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Procedure Code L6028 Update for Prosthetist and Orthotist Providers

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Beginning March 26, 2026, procedure code L6028 is a payable benefit for prosthetist providers for dates of service on or after April 1, 2025.

When processing claims for procedure code L6028 on or after April 1, 2026, Texas Medicaid may have erroneously reimbursed the claims for orthotist providers and denied the claims for prosthetist providers. Texas Medicaid does not reimburse orthotist providers for procedure code L6028.

Texas Medicaid will reprocess any claims that are affected by this update. If there are any recoupments of claims reimbursements or additional reimbursement payments due, they will be reflected on future Remittance and Status (R&S) Reports.

Note: Procedure code L6028 is a payable benefit for prosthetist and durable medical equipment (DME) suppliers.

For more information, call the Texas Medicaid & Healthcare Partnership (TMHP) Contact Center at 800-925-9126.