Texas MedicaidMedium ImpactCoverage

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

Published April 4, 2026Effective April 2, 2026

AI Summary

Beginning April 2, 2026, orthotists enrolled in the Texas CSHCN Services Program can no longer bill procedure code L6028 for dates of service on or after April 1, 2025. Only prosthetists and DME suppliers can still bill this code to Texas Medicaid.

Action Required

By April 2, 2026: Orthotists enrolled in Texas CSHCN Services Program must stop billing L6028 for all dates of service April 1, 2025 and after. Update billing system to block L6028 claims for orthotists in CSHCN program. Verify provider enrollment status and specialty type before submitting L6028 claims. Contact TMHP-CSHCN at 800-568-2413 for clarification if needed.

Affected Billing Codes

L6028

Plan Types

Medicaid

States

TX

Specialties

pm-r