Addition to ctlso or scoliosis orthosis, thoracic pad
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 1 units per day (clinical), rationale: Nature of Equipment
DME supplier: max 1 units per day (clinical), rationale: Nature of Equipment
Medicare pricing for L1060
DMEPOS fee schedule, July 2026 (DME26-C)
no modifier, prosthetics and orthotics (PO): non-rural $109.90 to $146.53 in the contiguous states; $81.66 to $170.96 in AK, HI, PR and VI; ceiling $146.53, floor $109.90
Payer policies and prior authorization for L1060
Payer coverage policies that name L1060
L1060 appears in 5 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, BlueCross BlueShield of South Carolina, Cigna.
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.