HCPCS L1970: Ankle-Foot Orthosis, plastic with ankle joint

Obtain a list of documentation and billing requirements needed to properly use and bill for HCPCS L1970 from our short guide.

Use Code

Frequently asked questions

Use L1970 when the AFO is custom-fabricated (made from a mold or model) and includes an articulated ankle joint. If it's prefabricated, even with fitting, use L1971 for proper billing.

It's possible to bill L1970 with certain add-on codes (e.g., L2820) for additional components. However, services like the initial evaluation, casting, and fitting are bundled into the L1970 code and cannot be billed separately.

No prior authorization is required under CMS’s master list, but a face-to-face encounter and written order are mandatory before delivery. Some Medicare Administrative Contractors (MACs) may place L1970 under review or require prior authorization through specific programs. Many state Medicaid programs and commercial insurers do require prior authorization, so always confirm requirements with the payer before fabrication and delivery.