HCPCS Code L1951: Ankle Foot Orthosis, Spiral, (Institute of Rehabilitative Medicine Type)

HCPCS code L1951 is for a spiral ankle foot orthosis (AFO) of the Institute of Rehabilitative Medicine type. It is a prefabricated plastic or other material device that has been trimmed, bent, molded, or otherwise customized to fit a specific patient by an expert. This custom-fitted orthosis provides support and controlled movement for the ankle and foot.

Medicare covers HCPCS code L1951 for dates of service on or after August 12, 2024, with prior authorization required. Coverage includes custom-fitted spiral ankle foot orthoses that are prefabricated and modified to fit the patient. Proper documentation and medical necessity must be met for reimbursement.

Ankle Foot Orthoses (AFOs) are generally covered by insurance, including Medicare, when medically necessary and prescribed by a healthcare provider. Coverage requires documentation of medical need, proper prescription, and sometimes prior authorization. Coverage varies by insurer and policy but is common for treating weakness or deformity in the lower limb.