Traditional MedicareCoverageMedium impact
Ankle-Foot/Knee-Ankle-Foot Orthosis
Medicare/CMS - LCD·Orthopedics, PM&R (Physical Medicine & Rehab), Podiatry·Local Coverage Determination
Effective date
Apr 1, 2026
We identified it
Jun 17, 2026
Summary
This is a Local Coverage Determination (LCD) for Ankle-Foot/Knee-Ankle-Foot Orthosis from CGS Administrators and Noridian Healthcare Solutions DME MACs, effective April 1, 2026. The policy establishes coverage criteria and billing requirements for these orthotic devices under Medicare.
Action Required
By April 1, 2026: Billing team must review the complete LCD L33686 policy document to understand specific coverage criteria, documentation requirements, and billing guidelines for ankle-foot and knee-ankle-foot orthoses. Update billing procedures to comply with CGS and Noridian DME MAC requirements for Medicare patients requiring these orthotic devices.