L9900 O&p supply/accessory/service

Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for L9900

5 of 5 payer prior-auth lists that name L9900 require prior authorization or set conditions: Blue Shield of California Promise Health Plan, Humana.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of California Promise Health PlanPromise Health Plan Medi-CalCAprior auth requiredSep 1, 2026Medi-Cal Prior Authorization List
HumanaHumana Healthy HorizonsOKprior auth requiredJan 1, 2027Humana Healthy Horizons® in Oklahoma Prior Authorization Notification List (PAL) The following preauthorization and notification list
HumanaHumana Healthy HorizonsSCprior auth requiredJan 1, 2027Humana Healthy Horizons in South Carolina Prior authorization and Notification List The following list describes services and medications that are commonly reviewed and may require additional clinical
HumanaHumana Healthy HorizonsSCprior auth requiredJan 1, 2027Humana Healthy Horizons in South Carolina Prior authorization and Notification List The following list describes services and medications that are commonly reviewed and may require additional clinical
HumanaOak Street HealthAllprior auth requiredOak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management

Medicaid fee-for-service

Prior authorization required or conditional in CO, IL, LA, MD, MS, ND, NY, OH, VA, WA.

  • KY: $0.00 (asc), effective Jan 1, 2026
  • ND: $0.00 (dme), effective Aug 1, 2026
  • NY: $5.05 (dme), effective Jul 1, 2026
  • OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

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.