MyMedi-AI

L8616 — Microphone for use with cochlear implant device, replacement

HCPCS Level II L-code · short descriptor: “Coch implant microphone repl”

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.

L8616 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $126.26 to $131.00 depending on state and rural status.

Former-CBA payment limits: ceiling $154.11 · floor $115.58

StateNon-ruralRural
AL$130.06—
AR$130.05—
AZ$126.26—
CA$126.26—
CO$131.00—
CT$126.26—
DC$126.26—
DE$126.26—
FL$130.06—
GA$130.06—
IA$128.72—
ID$126.26—
IL$129.34—
IN$129.34—
KS$128.72—
KY$130.06—
LA$130.05—
MA$126.26—
MD$126.26—
ME$126.26—
MI$129.34—
MN$129.34—
MO$128.72—
MS$130.06—
MT$131.00—
NC$130.06—
ND$131.00—
NE$128.72—
NH$126.26—
NJ$126.26—
NM$130.05—
NV$126.26—
NY$126.26—
OH$129.34—
OK$130.05—
OR$126.26—
PA$126.26—
RI$126.26—
SC$130.06—
SD$131.00—
TN$130.06—
TX$130.05—
UT$131.00—
VA$126.26—
VT$126.26—
WA$126.26—
WI$129.34—
WV$126.26—
WY$131.00—
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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