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MedicaidCoverageMedium impact

Prosthetics - MEDICAID - FLORIDA (New)

Humana·FL · Orthopedics, Plastic Surgery, Ophthalmology +2 more·Medicaid
Effective date
Feb 20, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

This is a new comprehensive prosthetics coverage policy for Florida Medicaid that establishes coverage criteria for various prosthetic devices including upper/lower limb prostheses, facial prosthetics, artificial corneas, and specialized devices like OPRA systems. The policy defines specific eligibility requirements and covered codes for each type of prosthetic device.

Action Required

Action needed
Before February 20, 2026: Billing team must review and update prosthetics billing procedures for Florida Medicaid patients. Ensure documentation supports specific coverage criteria for each prosthetic type (age requirements, amputation level, medical necessity). Update billing software with covered codes and create prior authorization workflows where required. Train staff on new eligibility requirements for specialized devices like OPRA systems.

Affected Billing Codes

21081
21082
21084
21086
21088
L8044
L8609
V2623
V2627
L5961
L5991
L8699
L3250