4 commercial payer policies list L6695. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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4 policies from 4 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of L6695 |
|---|---|---|
| Upper Limb Prostheses | Jun 6, 2023 | Covered |
| Policy | Effective | Status of L6695 |
|---|---|---|
| Upper Extremity Prosthetic Devices | Apr 1, 2026 | Covered |
| Policy | Effective | Status of L6695 |
|---|---|---|
| Upper Extremity Prosthetic Devices | Apr 1, 2026 | Covered |
| Policy | Effective | Status of L6695 |
|---|---|---|
| Upper Extremity Prosthetic Devices | Apr 1, 2026 | Covered |