L1001 HCPCS code: Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment
L1001 is the HCPCS Level II code for cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2007-01-01 |
| Last action effective | 2007-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Anatomic Consideration |
| outpatient hospital claims | 1 | Anatomic Consideration |
What changed for L1001
- 2007-01-01: L1001 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L1001?
L1001 is the HCPCS Level II code for cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment. Short descriptor: "Ctlso infant immobilizer".
Does Medicare cover L1001?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of L1001 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related L10 codes
- L1000 — Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model ($2,332.97–$4,062.52)
- L1005 — Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment ($3,839.20–$4,223.13)
- L1006 — Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($1,309.09–$1,309.09)
- L1007 — Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and interface, custom fabricated
- L1010 — Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling ($51.03–$102.83)
- L1020 — Addition to ctlso or scoliosis orthosis, kyphosis pad ($66.65–$184.59)
- L1025 — Addition to ctlso or scoliosis orthosis, kyphosis pad, floating ($143.30–$323.62)
- L1030 — Addition to ctlso or scoliosis orthosis, lumbar bolster pad ($71.58–$97.47)
- L1040 — Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad ($51.17–$166.02)
- L1050 — Addition to ctlso or scoliosis orthosis, sternal pad ($51.17–$141.90)
- L1060 — Addition to ctlso or scoliosis orthosis, thoracic pad ($81.66–$170.96)
- L1070 — Addition to ctlso or scoliosis orthosis, trapezius sling ($68.51–$144.98)
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Next steps
- Run a reimbursement report for a device billed under L1001
- Watch L1001 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1001
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.