Skip to main content

New Prosthesis Benefits for the CSHCN Services Program Effective July 1, 2025

Last updated on

Effective for dates of service on or after July 1, 2025, prosthesis procedure codes L5827 and L6700 are benefits of the Children with Special Health Care Needs (CSHCN) Services Program for clients who are 20 years of age or younger.

Beginning August 1, 2025, procedure codes L5827 and L6700 will require prior authorization. Refer to the current CSHCN Services Program Provider Manual, “Orthotic and Prosthetic Devices,” subsection 28.4, “Prostheses and Related Services,” for additional information about prior authorization criteria.

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.