What insurance policy changes affect HCPCS L1755?

There are 8 tracked policy changes affecting HCPCS L1755, including updates from Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS L1755?

Payers that have issued tracked updates for HCPCS L1755 include: Humana.

How do I get notified when HCPCS L1755 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS L1755. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for HCPCS L1755?

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.

L1755 Insurance Policy Changes

HCPCS L1755 is officially defined as "Legg perthes orthosis, (patten bottom type), custom fabricated." HCPCS L1755 is referenced in 8 tracked payer policy changes from Humana. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS L1755 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact
Orthotics - MEDICAID - KENTUCKY (Revised)
Humana·Effective Oct 14, 2026
Humana Kentucky Medicaid has revised its Orthotics coverage policy, effective 2026-10-14. The policy establishes medical necessity criteria, prior authorization requirements, and specific HCPCS codes for coverage of braces, splints, casts, and other orthotic devices across lower extremity, foot, spine, and upper extremity categories. Billing teams must verify prior authorization is obtained before claims submission and ensure documentation supports medical necessity for each orthotic type.
High impact
Orthotics - MEDICAID - KENTUCKY (Revised)
Humana·Effective Oct 14, 2026
Humana Kentucky Medicaid revised its Orthotics policy (HUM-KY-2177-001), effective 2026-10-14. The policy establishes coverage criteria and prior authorization requirements for orthotics including braces, splints, casts, foot orthotics, spine orthotics, and upper extremity orthotics across multiple HCPCS codes. This is a full policy revision with an original effective date of 2025-06-03 and a new effective date of 2026-10-14.
High impact
Orthotics - MEDICAID - SOUTH CAROLINA (Revised)
Humana·Effective Sep 23, 2026
Humana SC Medicaid has issued a revised orthotics coverage policy (HUM-SC-2177-001) effective 09/23/2026 that establishes medical necessity criteria for braces, splints, casts, and orthopedic devices across lower extremity, foot, and spine categories. The policy specifies which HCPCS codes are covered and requires detailed clinical documentation and physician prescriptions for approval. Billing teams must ensure claims include proper medical justification aligned with the specific clinical criteria outlined for each orthotic type.
High impact
Orthotics - MEDICAID - KENTUCKY (New)
Humana·Effective Dec 1, 2025
Humana Medicaid in Kentucky has established a new comprehensive orthotics policy (HUM-2177-000) defining coverage criteria for various orthotic devices including braces, splints, and supports. The policy specifies medical necessity requirements and covered HCPCS codes for lower extremity, foot, and spine orthotics.
High impact
Orthotics - MEDICAID - FLORIDA (New)
Humana·Effective Nov 5, 2025
Humana has released a new Medicaid policy for Florida that establishes comprehensive coverage criteria for various orthotic devices including braces, splints, supports, and custom orthotics. The policy defines medical necessity requirements and covers specific HCPCS codes for lower extremity, foot, and spine orthotics.
High impact
Orthotics - MEDICAID - VIRGINIA (New)
Humana·Effective Jul 1, 2025
New Humana Medicaid policy for Virginia establishes coverage criteria for various orthotic devices including braces, splints, and supports. The policy details specific HCPCS codes and medical necessity requirements for lower extremity, foot, and spine orthotics effective July 1, 2025.
High impact
Orthotics - MEDICAID - SOUTH CAROLINA (New)
Humana·Effective Jun 3, 2025
Humana has established a new comprehensive orthotics coverage policy for South Carolina Medicaid members, defining coverage criteria for various orthotic devices including braces, splints, supports, and specialty items. The policy provides specific HCPCS codes and medical necessity requirements for lower extremity, foot, and spine orthotics.
Medium impact
Orthotics - MEDICAID - VIRGINIA (Revised)
Humana·Effective Oct 14, 2026
Humana revised its Virginia Medicaid orthotics coverage policy, effective 2026-10-14. The policy specifies covered orthotic types (braces, splints, casts, exoskeletons) with detailed HCPCS codes and medical necessity criteria for lower extremity, spine, and specialized orthotics. Billing teams must ensure claims for orthotics include proper clinical documentation and align with the specified coverage instructions for each orthotic type.

All billing codes J3590 C9399 J3490 99213 99214 99212

Get alerts for changes like this

Save a search and receive a daily digest whenever a new policy change matches your filters.

Create a free alert

Orthotics - MEDICAID - KENTUCKY (Revised)

Orthotics - MEDICAID - KENTUCKY (Revised)

Orthotics - MEDICAID - SOUTH CAROLINA (Revised)

Orthotics - MEDICAID - KENTUCKY (New)

Orthotics - MEDICAID - FLORIDA (New)

Orthotics - MEDICAID - VIRGINIA (New)

Orthotics - MEDICAID - SOUTH CAROLINA (New)

Orthotics - MEDICAID - VIRGINIA (Revised)