MyMedi-AI

L2020 — Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated

HCPCS Level II L-code · short descriptor: “Kafo dbl solid stirrup band/”

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.

L2020 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1341.77 to $3211.79 depending on state and rural status.

Former-CBA payment limits: ceiling $1789.03 · floor $1341.77

StateNon-ruralRural
AK$3003.63—
AL$1341.77—
AR$1341.77—
AZ$1789.03—
CA$1789.03—
CO$1341.77—
CT$1706.53—
DC$1425.40—
DE$1425.40—
FL$1341.77—
GA$1341.77—
HI$3211.79—
IA$1341.77—
ID$1789.03—
IL$1354.33—
IN$1354.33—
KS$1341.77—
KY$1341.77—
LA$1341.77—
MA$1706.53—
MD$1425.40—
ME$1706.53—
MI$1354.33—
MN$1354.33—
MO$1341.77—
MS$1341.77—
MT$1341.77—
NC$1341.77—
ND$1341.77—
NE$1341.77—
NH$1706.53—
NJ$1457.75—
NM$1341.77—
NV$1789.03—
NY$1457.75—
OH$1354.33—
OK$1341.77—
OR$1789.03—
PA$1425.40—
PR$1856.00—
RI$1706.53—
SC$1341.77—
SD$1341.77—
TN$1341.77—
TX$1341.77—
UT$1341.77—
VA$1425.40—
VI$1457.75—
VT$1706.53—
WA$1789.03—
WI$1354.33—
WV$1425.40—
WY$1341.77—
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 L2020 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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