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News update

Apr 08, 2026

Orthotists in the CSHCN Services Program Should Review the L6028 Procedure Code Update

A significant reimbursement policy change has been announced affecting orthotists enrolled in the Children with Special Health Care Needs (CSHCN) Services Program. Effective April 2, 2026, procedure code L6028 will no longer be reimbursable for orthotists for dates of service on or after April 1, 2025.

However, TMHP has confirmed that reimbursement for procedure code L6028 may still be available when billed by prosthetists and durable medical equipment (DME) suppliers, provided all applicable billing guidelines and requirements are met.

For additional details or clarification, providers can contact the TMHP-CSHCN Services Program Contact Center at 800-568-2413.

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