The Centers for Medicare & Medicaid Services (CMS) released its final determinations from the Second Biannual 2025 Healthcare Common Procedure Coding System (HCPCS) code application meetings. For O&P, CMS added two new L-codes, deleted three codes, and changed one descriptor. The update also finalized the Medicare fee schedule amounts for previously created O&P codes L-5657, L-6029, L-6030, L-6031, L-6032, L-6033, and L-6037. The changes are valid for claims with dates of service on or after April 1.
The new codes and descriptors are as follows:
- L-2221: Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source
- L-5992: All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only
The descriptor for HCPCS code L-6028 was changed as follows:
- Previous: Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, including palm, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by L-6692
- New: Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by L-6692
The deleted HCPCS codes were as follows:
- L-6000, partial hand, thumb remaining
- L-6010, partial hand, little and/or ring finger remaining
- L-6020, partial hand, no finger remaining
To download the fee schedule and the fee schedule amounts, visit the CMS website.
