MyMedi-AI

L8619 — Cochlear implant, external speech processor and controller, integrated system, replacement

HCPCS Level II L-code · short descriptor: “Coch imp ext proc/contr rplc”

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.

L8619 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $9873.11 to $10367.03 depending on state and rural status.

Former-CBA payment limits: ceiling $12177.04 · floor $9132.78

StateNon-ruralRural
AL$10053.97—
AR$10172.28—
AZ$10367.03—
CA$10367.03—
CO$10203.60—
CT$10062.46—
DC$10248.40—
DE$10248.40—
FL$10053.97—
GA$10053.97—
IA$9971.45—
ID$9873.11—
IL$10350.06—
IN$10350.06—
KS$9971.45—
KY$10053.97—
LA$10172.28—
MA$10062.46—
MD$10248.40—
ME$10062.46—
MI$10350.06—
MN$10350.06—
MO$9971.45—
MS$10053.97—
MT$10203.60—
NC$10053.97—
ND$10203.60—
NE$9971.45—
NH$10062.46—
NJ$10071.29—
NM$10172.28—
NV$10367.03—
NY$10071.29—
OH$10350.06—
OK$10172.28—
OR$9873.11—
PA$10248.40—
RI$10062.46—
SC$10053.97—
SD$10203.60—
TN$10053.97—
TX$10172.28—
UT$10203.60—
VA$10248.40—
VT$10062.46—
WA$9873.11—
WI$10350.06—
WV$10248.40—
WY$10203.60—
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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