MyMedi-AI

L0180 — Cervical, multiple post collar, occipital/mandibular supports, adjustable

HCPCS Level II L-code · short descriptor: “Cer post col occ/man sup adj”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Prosthetics & orthotics
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L0180 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $425.78 to $587.47 depending on state and rural status.

Former-CBA payment limits: ceiling $567.70 · floor $425.78

StateNon-ruralRural
AK$549.39—
AL$429.30—
AR$473.00—
AZ$545.66—
CA$545.66—
CO$425.78—
CT$567.70—
DC$437.72—
DE$437.72—
FL$429.30—
GA$429.30—
HI$587.47—
IA$428.95—
ID$483.66—
IL$554.45—
IN$554.45—
KS$428.95—
KY$429.30—
LA$473.00—
MA$567.70—
MD$437.72—
ME$567.70—
MI$554.45—
MN$554.45—
MO$428.95—
MS$429.30—
MT$425.78—
NC$429.30—
ND$425.78—
NE$428.95—
NH$567.70—
NJ$466.05—
NM$473.00—
NV$545.66—
NY$466.05—
OH$554.45—
OK$473.00—
OR$483.66—
PA$437.72—
PR$476.70—
RI$567.70—
SC$429.30—
SD$425.78—
TN$429.30—
TX$473.00—
UT$425.78—
VA$437.72—
VI$466.05—
VT$567.70—
WA$483.66—
WI$554.45—
WV$437.72—
WY$425.78—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L0180 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

Related L-codes

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