MyMedi-AI

L8615 — Headset/headpiece for use with cochlear implant device, replacement

HCPCS Level II L-code · short descriptor: “Coch implant headset replace”

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
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.

L8615 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $542.05 to $562.60 depending on state and rural status.

Former-CBA payment limits: ceiling $661.66 · floor $496.25

StateNon-ruralRural
AL$558.37—
AR$558.34—
AZ$542.05—
CA$542.05—
CO$562.60—
CT$542.05—
DC$542.05—
DE$542.05—
FL$558.37—
GA$558.37—
IA$552.63—
ID$542.05—
IL$555.35—
IN$555.35—
KS$552.63—
KY$558.37—
LA$558.34—
MA$542.05—
MD$542.05—
ME$542.05—
MI$555.35—
MN$555.35—
MO$552.63—
MS$558.37—
MT$562.60—
NC$558.37—
ND$562.60—
NE$552.63—
NH$542.05—
NJ$542.05—
NM$558.34—
NV$542.05—
NY$542.05—
OH$555.35—
OK$558.34—
OR$542.05—
PA$542.05—
RI$542.05—
SC$558.37—
SD$562.60—
TN$558.37—
TX$558.34—
UT$562.60—
VA$542.05—
VT$542.05—
WA$542.05—
WI$555.35—
WV$542.05—
WY$562.60—
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.

Common denial codes to watch

Related L-codes

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