What insurance policy changes affect HCPCS L6028?

There are 10 tracked policy changes affecting HCPCS L6028, including updates from Kansas Medicaid (KanCare), CareSource, Blue Cross Blue Shield of Rhode Island. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS L6028?

Payers that have issued tracked updates for HCPCS L6028 include: Kansas Medicaid (KanCare), CareSource, Blue Cross Blue Shield of Rhode Island, Texas Medicaid, Michigan Medicaid - MDHHS, Pennsylvania Medicaid (DHS).

How do I get notified when HCPCS L6028 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS L6028. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for HCPCS L6028?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

L6028 — 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 l6692: Insurance Policy Changes

L6028 Insurance Policy Changes

HCPCS L6028 is officially defined as "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 l6692." HCPCS L6028 is referenced in 10 tracked payer policy changes from Kansas Medicaid (KanCare), CareSource, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS L6028 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

KMAP BULLETIN: Partial Hand Prosthesis Coverage Update – L6028

Kansas Medicaid (KanCare)·Effective Apr 1, 2026

Kansas Medicaid (KMAP) is replacing discontinued prosthetic codes L6000, L6010, and L6020 with new code L6028 (partial hand prosthesis) effective April 1, 2026, with reimbursement set at $1,793.28 (80% of Medicare rate). Billing teams must transition all partial hand prosthesis claims to L6028 and verify MCO implementation timelines, as KanCare MCOs may implement on different dates.

L6028 Insurance Policy Changes

KMAP BULLETIN: Partial Hand Prosthesis Coverage Update – L6028

[Ohio] Prior Authorization Requirement Update

[Georgia] Prior Authorization Requirement Update

[Georgia] Prior Authorization Requirement Update

Additional HCPCS Level II Code Changes and Modifier Changes

Payment Policies

Procedure Code L6028 Update for Orthotists Enrolled in the CSHCN Services Program

MMP 26-15: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

mab2025111301

Procedure Code L6028 Update for Prosthetist and Orthotist Providers