L0190 Cerv collar supp adj cerv ba

Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for L0190

DMEPOS fee schedule, July 2026 (DME26-C)

Payer policies and prior authorization for L0190

1 of 1 payer prior-auth lists that name L0190 require prior authorization or set conditions: Passport by Molina Healthcare (Kentucky).

PayerPlanStatePrior authConditionsSinceSource
Passport by Molina Healthcare (Kentucky)MedicaidKYprior auth under conditionsState exception; PA above 1 unit per yearJul 1, 2026Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026

Payer coverage policies that name L0190

L0190 appears in 3 coverage policies from Aetna, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaBack Pain - Invasive Procedures (0016)listed, no stance (range L0112-L0999)Oct 6, 2026payer document
AetnaOrthopedic Casts, Braces and Splints (0009)listed, no stance (range L0130-L0200)Jan 20, 2026payer document
CignaOrthotic Devices and Shoes (0543)covered if criteria are metSep 15, 2026payer document

Recent prior-auth changes

  • Jul 1, 2026: conditions changed, Passport by Molina Healthcare (Kentucky)
  • Oct 1, 2025: conditions changed, Passport by Molina Healthcare (Kentucky)
  • Jul 1, 2025: conditions changed, Passport by Molina Healthcare (Kentucky)

Medicaid fee-for-service

Prior authorization required or conditional in CO, LA, MA, MS, NY, OH, VA.

  • AZ: $706.53 (dme), effective Oct 1, 2026
  • CO: $405.60 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $301.83 (dme), effective Jul 1, 2026
  • IL: $483.20 (dme), effective Jan 1, 2026
  • IN: $544.93 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KS: $482.40 (default), effective Jul 1, 2026
  • KY: $403.80 (dme), effective Jan 1, 2026
  • LA: $332.51 (dme), effective Jul 1, 2012
  • MA: $526.44 (orthotics_prosthetics_rates), effective Apr 1, 2024
  • MD: $483.85 (dme), effective Apr 1, 2026
  • MS: $517.01 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (dme), effective Aug 1, 2026
  • NE: $517.75 (dme), effective Jul 1, 2026
  • NY: $314.87 (dme), effective Jul 1, 2026
  • OH: $339.95 (dme), effective Jan 1, 2010
  • OK: $428.76 (dme), effective Jan 1, 2026
  • TX: $325.78 (dmepos_tos_9_e_j_l_and_r, Hospital - Long Term, Limited, Or Specialized Ca, facility), effective Apr 1, 1992
  • VA: $512.31 (dme), effective Dec 1, 2026
  • VT: $576.70 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $511.42 (prosthetics_orthotics), effective Jul 1, 2026
  • WY: $389.43 (professional), effective Jan 1, 2021

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.