L1906 — Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Afo multilig ank sup pre ots”
- 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
- Required from 2026-10-28 (Orthoses)
- MUE unit limit
- 2
- 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))
F2F + WOPD FROM 2026-10-28 L1906 joins Medicare's Required Face-to-Face & WOPD List for dates of service on or after 2026-10-28 (Orthoses — CMS-6109-N, 91 FR 47972 (published 2026-07-30)). From that date two extra conditions of payment apply:
- Face-to-face encounter (in-person or telehealth) with the treating practitioner within the 6 months before the order date
- Written order communicated to the supplier before delivery (WOPD)
Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.
L1906 Medicare fee schedule (October 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $138.20 to $318.48 depending on state and rural status.
Former-CBA payment limits: ceiling $184.26 · floor $138.20
| State | Non-rural | Rural |
|---|---|---|
| AK | $297.85 | — |
| AL | $157.92 | — |
| AR | $138.20 | — |
| AZ | $184.26 | — |
| CA | $184.26 | — |
| CO | $184.26 | — |
| CT | $154.75 | — |
| DC | $138.20 | — |
| DE | $138.20 | — |
| FL | $157.92 | — |
| GA | $157.92 | — |
| HI | $318.48 | — |
| IA | $138.20 | — |
| ID | $138.20 | — |
| IL | $138.20 | — |
| IN | $138.20 | — |
| KS | $138.20 | — |
| KY | $157.92 | — |
| LA | $138.20 | — |
| MA | $154.75 | — |
| MD | $138.20 | — |
| ME | $154.75 | — |
| MI | $138.20 | — |
| MN | $138.20 | — |
| MO | $138.20 | — |
| MS | $157.92 | — |
| MT | $184.26 | — |
| NC | $157.92 | — |
| ND | $184.26 | — |
| NE | $138.20 | — |
| NH | $154.75 | — |
| NJ | $139.58 | — |
| NM | $138.20 | — |
| NV | $184.26 | — |
| NY | $139.58 | — |
| OH | $138.20 | — |
| OK | $138.20 | — |
| OR | $138.20 | — |
| PA | $138.20 | — |
| PR | $142.76 | — |
| RI | $154.75 | — |
| SC | $157.92 | — |
| SD | $184.26 | — |
| TN | $157.92 | — |
| TX | $138.20 | — |
| UT | $184.26 | — |
| VA | $138.20 | — |
| VI | $139.66 | — |
| VT | $154.75 | — |
| WA | $138.20 | — |
| WI | $138.20 | — |
| WV | $138.20 | — |
| WY | $184.26 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps L1906 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.
Common denial codes to watch
Related L-codes
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