MyMedi-AI

L1910 — Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment

HCPCS Level II L-code · short descriptor: “Afo sing bar clasp attach sh”

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
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))

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.

L1910 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $307.30 to $590.09 depending on state and rural status.

Former-CBA payment limits: ceiling $409.73 · floor $307.30

StateNon-ruralRural
AK$490.77—
AL$307.30—
AR$346.21—
AZ$409.73—
CA$409.73—
CO$310.68—
CT$364.33—
DC$313.83—
DE$313.83—
FL$307.30—
GA$307.30—
HI$524.77—
IA$307.30—
ID$388.69—
IL$344.65—
IN$344.65—
KS$307.30—
KY$307.30—
LA$346.21—
MA$364.33—
MD$313.83—
ME$364.33—
MI$344.65—
MN$344.65—
MO$307.30—
MS$307.30—
MT$310.68—
NC$307.30—
ND$310.68—
NE$307.30—
NH$364.33—
NJ$382.27—
NM$346.21—
NV$409.73—
NY$382.27—
OH$344.65—
OK$346.21—
OR$388.69—
PA$313.83—
PR$590.09—
RI$364.33—
SC$307.30—
SD$310.68—
TN$307.30—
TX$346.21—
UT$310.68—
VA$313.83—
VI$382.27—
VT$364.33—
WA$388.69—
WI$344.65—
WV$313.83—
WY$310.68—
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 L1910 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

Bill L1910 with confidence

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