MyMedi-AI

L6930 — Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device

HCPCS Level II L-code · short descriptor: “Below elbow switch control”

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.

L6930 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $6795.44 to $10435.11 depending on state and rural status.

Former-CBA payment limits: ceiling $10961.27 · floor $8220.96

StateNon-ruralRural
AK$8542.82
AL$8220.96
AR$9631.82
AZ$8495.44
CA$8495.44
CO$10435.11
CT$9103.80
DC$8927.42
DE$8927.42
FL$8220.96
GA$8220.96
HI$9134.88
IA$9119.06
ID$10335.88
IL$9934.80
IN$9934.80
KS$9119.06
KY$8220.96
LA$9631.82
MA$9103.80
MD$8927.42
ME$9103.80
MI$9934.80
MN$9934.80
MO$9119.06
MS$8220.96
MT$10435.11
NC$8220.96
ND$10435.11
NE$9119.06
NH$9103.80
NJ$8220.96
NM$9631.82
NV$8495.44
NY$8220.96
OH$9934.80
OK$9631.82
OR$10335.88
PA$8927.42
PR$6795.44
RI$9103.80
SC$8220.96
SD$10435.11
TN$8220.96
TX$9631.82
UT$10435.11
VA$8927.42
VI$8220.96
VT$9103.80
WA$10335.88
WI$9934.80
WV$8927.42
WY$10435.11
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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