Back to dashboard
CommercialCoverageMedium impact

Microprocessor-Controlled Prostheses for the Lower Limb

Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, PM&R (Physical Medicine & Rehab), General Surgery·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

BCBS MS updated their policy for microprocessor-controlled lower limb prostheses, establishing specific medical necessity criteria including requirements for long-distance ambulation at variable rates or regular use on uneven terrain/stairs, plus adequate cardiovascular reserve and cognitive ability. Microprocessor-controlled ankles and powered knees remain investigational.

Action Required

Action needed
Immediately: Review current microprocessor-controlled prostheses authorizations to ensure patients meet new criteria (long-distance variable-rate ambulation OR regular uneven terrain/stair use, plus cardiovascular reserve and cognitive ability). Update prior authorization templates to document these specific requirements. Inform prosthetists that microprocessor ankles and powered knees are considered investigational and not covered.

Related policy hubs