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Additional HCPCS Codes Added to F2F/WOPD Required List

Published in Government Relations on January 16, 2023

On Jan. 14, 2023, CMS released a public notice CMS-6088-N, adding 10 more HCPCS codes to the F2F/WOPD Required List. The effective date for these 10 new HCPCS codes in the brace category is April 2023.

The new codes include the following for back, knee, and ankle/foot braces:

L0631
L0637
L1843
L1932
L1940
L1951
L1960
L1970
L2005
L2036

The F2F Encounter/WOPD Required List already includes all HCPCS codes in the PMD product category and seven HCPCS codes effective nationally in 2022. With the 10 new codes, this makes the Required List for F2F/WOPD up to 63 HCPCS codes.

CMS has a webpage dedicated to information for suppliers. When a code makes the Required F2F/WOPD List, a patient must have a face-to-face encounter with their treating practitioner documenting the medical necessity for the item being prescribed. The medical necessity must meet the coverage criteria outlined within the respective medical policy (LCD).

In addition, the written order prior to delivery is required and must be completed within six months after the required F2F encounter. The Standard Documentation Requirements Policy includes these details.

If you have questions, please contact Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement.

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