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L0970 — Tlso, corset front

HCPCS Level II L-code · short descriptor: “Tlso corset front”

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
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). 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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

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

L0970 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $81.66 to $221.47 depending on state and rural status.

Former-CBA payment limits: ceiling $175.12 · floor $131.34

StateNon-ruralRural
AK$207.10
AL$131.34
AR$167.07
AZ$175.12
CA$175.12
CO$175.12
CT$131.34
DC$154.52
DE$154.52
FL$131.34
GA$131.34
HI$221.47
IA$131.34
ID$131.34
IL$131.34
IN$131.34
KS$131.34
KY$131.34
LA$167.07
MA$131.34
MD$154.52
ME$131.34
MI$131.34
MN$131.34
MO$131.34
MS$131.34
MT$175.12
NC$131.34
ND$175.12
NE$131.34
NH$131.34
NJ$135.93
NM$167.07
NV$175.12
NY$135.93
OH$131.34
OK$167.07
OR$131.34
PA$154.52
PR$81.66
RI$131.34
SC$131.34
SD$175.12
TN$131.34
TX$167.07
UT$175.12
VA$154.52
VI$135.94
VT$131.34
WA$131.34
WI$131.34
WV$154.52
WY$175.12
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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.

Common denial codes to watch

Related L-codes

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