Orthotics - MEDICAID - VIRGINIA

This Virginia Medicaid policy covers a broad range of orthotic devices — including braces, splints, supports, casts, custom modifications (e.g., L3649, L4060–L4080, L0830) and select powered exoskeleton systems — to support, align, immobilize or improve function for conditions such as deformities, fractures, tendonitis, neurological disorders, and ambulation for individuals with paraplegia from spinal cord injury. Coverage is conditional and subject to plan eligibility, medical necessity and documentation; select exoskeletons are limited (T4–T6 generally restricted to rehabilitation institutions, T7–L5 may require a specially trained caregiver and crutch use), and distinctions among OTC, prefabricated and custom-fabricated devices affect coverage.

"L3904: Wrist-hand-finger orthosis (WHFO), external powered, electric, custom fabricated"

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