MyMedi-AI

L0190 — Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)

HCPCS Level II L-code · short descriptor: “Cerv collar supp adj cerv ba”

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.

L0190 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $569.23 to $880.70 depending on state and rural status.

Former-CBA payment limits: ceiling $758.97 · floor $569.23

StateNon-ruralRural
AK$823.55—
AL$646.26—
AR$612.51—
AZ$758.97—
CA$758.97—
CO$591.05—
CT$687.99—
DC$569.23—
DE$569.23—
FL$646.26—
GA$646.26—
HI$880.70—
IA$603.00—
ID$680.47—
IL$653.92—
IN$653.92—
KS$603.00—
KY$646.26—
LA$612.51—
MA$687.99—
MD$569.23—
ME$687.99—
MI$653.92—
MN$653.92—
MO$603.00—
MS$646.26—
MT$591.05—
NC$646.26—
ND$591.05—
NE$603.00—
NH$687.99—
NJ$624.21—
NM$612.51—
NV$758.97—
NY$624.21—
OH$653.92—
OK$612.51—
OR$680.47—
PA$569.23—
PR$658.45—
RI$687.99—
SC$646.26—
SD$591.05—
TN$646.26—
TX$612.51—
UT$591.05—
VA$569.23—
VI$624.21—
VT$687.99—
WA$680.47—
WI$653.92—
WV$569.23—
WY$591.05—
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 L0190 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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