MyMedi-AI

L3020 — Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each

HCPCS Level II L-code · short descriptor: “Foot longitud/metatarsal sup”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Special coverage instructions apply
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.

L3020 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $237.97 to $261.73 depending on state and rural status.

Former-CBA payment limits: ceiling $290.42 · floor $217.81

StateNon-ruralRural
AK$237.97—
AL$245.15—
AR$245.12—
AZ$237.97—
CA$237.97—
CO$246.48—
CT$237.97—
DC$237.97—
DE$237.97—
FL$245.15—
GA$245.15—
HI$237.97—
IA$242.64—
ID$237.97—
IL$243.83—
IN$243.83—
KS$242.64—
KY$245.15—
LA$245.12—
MA$237.97—
MD$237.97—
ME$237.97—
MI$243.83—
MN$243.83—
MO$242.64—
MS$245.15—
MT$246.48—
NC$245.15—
ND$246.48—
NE$242.64—
NH$237.97—
NJ$237.97—
NM$245.12—
NV$237.97—
NY$237.97—
OH$243.83—
OK$245.12—
OR$237.97—
PA$237.97—
PR$261.73—
RI$237.97—
SC$245.15—
SD$246.48—
TN$245.15—
TX$245.12—
UT$246.48—
VA$237.97—
VI$261.73—
VT$237.97—
WA$237.97—
WI$243.83—
WV$237.97—
WY$246.48—
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 L3020 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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