101 CMR 334.00 — Rates for Prostheses, Prosthetic Devices, and Orthotic Devices

Final Adoption Date Published in Mass. Register: June 19, 2026 1

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

Section 334.01: General Provisions 334.02: General Definitions 334.03: General Rate Provisions 334.04: Reporting Requirements 334.05: Severability

101 CMR 334.00 Rates for Prostheses, Prosthetic Devices, and Orthotic Devices

334.01 General Provisions

334.01: General Provisions

(1) Scope and Purpose. 101 CMR 334.00 governs the payment rates to be used by all governmental units for prostheses, prosthetic devices, and orthotic devices provided to publicly aided individuals. The rates set forth in 101 CMR 334.00 do not apply to individuals covered by M.G.L. c. 152 (the Workers’ Compensation Act). Rates for services provided to these individuals are set forth in 114.3 CMR 40.03(2): Services and Rates Covered by Other Regulations.

(2) Applicable Dates of Service. Rates contained in 101 CMR 334.00 apply for dates of service provided on or after July 1, 2026, unless otherwise specified.

(3) Coverage. 101 CMR 334.00 and the payment rates established under 101 CMR 334.00 apply to the direct purchase and repair of prescribed custom-made prostheses and prosthetic devices manufactured and supplied by providers, including the cost of customized fitting and client service. 101 CMR 334.00 also applies to the purchase and repair of orthotic devices. These rates are full payment for prostheses, prosthetic devices, and orthotic devices provided by sale, as well as full payment for any related supervisory or administrative duties, fittings and adjustments rendered in connection with the provision of prostheses, prosthetic devices, and orthotic devices.

(4) Disclaimer of Authorization of Services. 101 CMR 334.00 is not authorization for or approval of the procedures for which rates are determined pursuant to 101 CMR 334.00. Governmental units that purchase care are responsible for the definition, authorization, and approval of care to publicly aided individuals.

(5) Coding Updates and Corrections. The Executive Office of Health and Human Services (EOHHS) may publish procedure code updates and corrections in the form of an Administrative Bulletin. The publication of such updates and corrections will list: (a) codes for which the code numbers only changed, with the corresponding crosswalk; (b) codes for which the codes remain the same, but the descriptions have changed; (c) deleted codes for which there are no crosswalks; and (d) entirely new codes. For new codes without Medicare fees as of the date of the Administrative Bulletin, EOHHS will apply individual consideration in establishing payment for such codes. Rates established by administrative bulletin will remain in effect until such time EOHHS adopts a revised regulation or superseding administrative bulletin.

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

2

334.02 General Definitions

334.02: General Definitions

As used in 101 CMR 334.00, unless the context requires otherwise, terms have the meanings in 101 CMR 334.02.

Above Elbow (AE) Trans-humeral. Relating to prostheses or levels of amputation across the long axis of the humerus.

Above Knee (AK) Trans-femoral. Relating to prostheses or levels of amputation across the long axis of the femur.

Additions to. If a code is listed as “Additions to”, the code is added to the base procedure code if additional and more complicated services are provided. The value assigned to the “Additions To” codes does not represent the actual value of the component but only the difference in value between the base procedure code and the additional component.

Adjusted Acquisition Cost (AAC). The price paid to a supplier by a provider for prostheses, prosthetic devices and orthotic devices after adjusting for manufacturer, dealer, trade, and volume discounts and excluding all associated costs such as, but not limited to, shipping, handling, and insurance costs. The AAC may not exceed the price to the provider as listed or determined in the manufacturer’s current catalogue and must be evidenced by a current invoice. The standard markup applied to the AAC corresponds to the complexity of the item and is set forth in 101 CMR 334.02.

Ankle foot orthosis (AFO). An orthosis beginning at the toes, crossing the ankle, and terminating on the calf. Devised to control, limit, or assist foot and ankle motion and provide leg support.

American Board for Certification in Orthotics, Prosthetics, and Pedorthics (ABC). An accrediting organization for orthotic, prosthetic, and pedorthic services.

Base Code. A code that describes the essential or fundamental design of a device.

Below Elbow (BE) Trans-radial. Relating to prostheses or levels of amputation across the long axis of the radius/ulna.

Below Knee (BK) Trans-tibial. Relating to prostheses or levels of amputation across the long axis of the tibia/fibula.

Bilateral. Of, or pertaining to, both sides of the body.

Board of Certification/Accreditation (BOC). An accrediting organization for prosthetic and orthotic services.

Center. The Center for Health Information and Analysis established under M.G.L. c. 12C.

Cervical Orthosis (CO). Orthosis that traverses the cervical vertebrae.

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

3 Cervical-thoracic Orthosis (CTO). Orthosis that traverses the listed areas.

Cervical-thoracic-lumbar-sacral Orthosis (CTLSO). Orthosis that traverses the listed areas.

Cross-walk. A cross-reference in which a code is deleted and replaced with another code or series of codes.

Custom Fabricated Device. A device or product made for a specific patient from their individual measurements and/or pattern.

Custom Fitted/Prefabricated. A prefabricated device or product that has been manufactured from standard molds or patterns and that requires modification for fitting by a certified orthotist or an individual who has equivalent specialized training.

Definitive Prosthesis. A prosthesis intended for long-term use containing components suitable for the full range of functional activities the amputee may be able to perform.

Direct Formed. Material is molded over the involved portion of the patient’s body and ultimately used as an essential part of the device.

Dynamic Response. A prosthetic foot with a spring keel which deflects under load and returns to neutral.

Early Fitting. A prosthetic device provided during the initial wound healing phase following amputation.

Elastic Keel Foot. See Flexible Keel Foot.

Elastic Type Material Being. Of, or with properties similar to, elastic.

Elbow Orthosis (EO). Orthosis that traverses the elbow.

Endoskeletal. A prosthesis composed of an internal pylon system that provides structural integrity to the device.

Energy Storing Foot. A prosthetic foot designed to collect a substantial amount of strain energy and return it to the gait cycle via deflection on the foot.

EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A.

Exoskeletal. A prosthesis composed of a rigid external shell which provides structural integrity to the device.

Fabrication and Fitting. Time spent in examining the patient; making necessary patterns and measurements; and performing fittings, including static and dynamic alignments and fitting refinements.

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

4 Finger Orthosis or Foot Orthosis (FO). Orthosis that traverses the finger or the foot. While this abbreviation represents two types of orthoses, these two types of orthoses are so different that the context will clearly indicate which is meant.

Flexible. Referring to devices which are bendable in nature and occasionally reinforced with stays of metal or other semi-rigid materials.

Flexible Keel Foot. A prosthetic foot with a compliant, elastomeric keel which absorbs forces during rollover.

Governmental Unit. The Commonwealth, any department, agency, board, or commission of the Commonwealth and any political subdivision of the Commonwealth.

Hand-finger Orthosis (HFO). Orthosis that traverses the listed areas.

Hand Orthosis (HO). Orthosis that encompasses the whole or any part of the hand.

Heavy Duty. Being of stronger nature than standard.

Hemi Pelvectomy – Trans-pelvic. Relating to an amputation which is performed through a portion of the pelvis or a prosthesis for this type of amputation.

Hip Disarticulation (HD). An amputation through the hip joint or to describe a prosthesis for this level of amputation.

Hip-knee-ankle-foot Orthosis (HKAFO). Orthosis that traverses the listed areas.

Immediate Fitting. Beginning prosthetic management immediately following surgical closure of the wound.

Individual Consideration (IC). Services or devices designated IC are items individually considered by the purchasing governmental unit based on the provider’s report of services. The purchasing governmental unit analyzes the provider's report of services submitted before making a determination. Providers must keep adequate records to substantiate their IC claims and must provide these documents including a copy of current invoice to the purchasing agency upon demand. See 101 CMR 334.02 for the definition of Standard Markup and 101 CMR 334.03(8).

Initial. Direct formed prosthetic devices provided as early as patient management.

Interface Material. Flexible lining material integral to the device.

Knee-ankle-foot Orthosis (KAFO). Orthosis that traverses the listed areas.

Knee Disarticulation (KD). Relating to an amputation that is performed through the knee joint or a prosthesis for this type of amputation.

Knee Orthosis (KO). Orthosis that traverses the knee.

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

5

Lumbar-sacral Orthosis (LSO). Orthosis that traverses the listed areas.

Molded Socket. In orthotics, this term refers to an impression that was taken and modified, and that a socket of thermoplastic or other material was made over the model. In prosthetics, this term refers to a generally accepted fitting procedure, such as PTB or quadrilateral socket, was molded over a modified patient model.

Molded to Patient. See Direct Formed.

Molded to Patient Model. Custom manufactured item individually fabricated over a positive model of the patient, based on a three-dimensional negative impression or digital scanning.

Multiaxial. Having two or more axes of rotation.

Multi-density. Composed of two or more materials of varying shore hardness.

Multi-durometer. Composed of two or more materials, with sectional areas of differing shore hardness.

Non-removable. Attached to shoe when the device is permanently affixed and therefore a part of the shoe.

Off-the-shelf. A prefabricated device or product that requires minimal self-adjustment as defined at 42 CFR 414.402 for appropriate use, i.e., does not require the services of a certified orthotist or an individual who has specialized training to adjust the device.

Orthosis. Externally applied device used to modify the structural and functional characteristics of the neuromuscular and skeletal systems.

Passive. A device that cannot be actively moved.

Polycentric. Having many centers of rotation in a single plane.

Prefabricated. A device that has been manufactured from standard molds or patterns.

Premolded. See Prefabricated.

Preparatory. A prosthetic device applied to prepare the limb for eventual fitting and to evaluate the appropriateness of selected technology and the patient’s ability to use a definitive prosthesis.

Production. See Prefabricated.

Prosthesis. Externally applied device used to replace wholly, or in part, an absent or deficient body segment.

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

6 Provider. Any person, partnership, corporation, or other entity that is authorized by the Commonwealth of Massachusetts to engage in the business of providing prosthetic, orthotic, or pedorthic services and related supplies. An eligible provider of prosthetic, orthotic, or pedorthic services and related supplies must be ABC-certified or BOC-certified and must meet the conditions of participation adopted by the purchasing governmental unit.

Publicly Aided Individual. A person for whose medical and other services a governmental unit is in whole or in part liable under a statutory program.

Recall. An action taken by the manufacturer to retrieve, replace, or repair dangerous or defective orthotic or prosthetic devices whether or not such action is taken at the direction of the Food and Drug Administration (FDA).

Retail Price. The total price charged for a product sold to a customer, which includes the manufacturer's cost plus a retail markup.

Rigid. Not bending; inflexible.

Sale Price. The price at which something sells or is sold after its retail price has been reduced.

Semi-rigid. Partially rigid; having some rigid elements.

Shelf Price. The sign or tag placed by an authorized person at each point of display that clearly sets forth the retail price of the item.

Shoulder-elbow-wrist-hand Orthosis (SEWHO). Orthosis that traverses the listed areas.

Shoulder Orthosis (SO). Orthosis that traverses the shoulder.

Single Axis. Having only one axis of rotation.

Standard Markup. Except where otherwise indicated in an applicable section of 101 CMR 334.03, the standard markup for the purchase of prostheses, prosthetic devices, and orthotic devices that is applied to the AAC, net of any discounts as specified in the definition of AAC at 101 CMR 334.02, to a supplier by an eligible provider cannot exceed:

1. 70% for any item described as being custom fabricated; or
2. 50% for any item described as being prefabricated; or
3. 40% for any item described as being off-the-shelf.

Thermoplastic. Able to be remolded with the application of heat.

Thoracic-lumbar-sacral Orthosis (TLSO). An orthosis that traverses the listed areas.

Thoracic Orthosis (TO). An orthosis that traverses the thoracic vertebrae.

Ultra-light Material. Materials such as titanium, carbon fiber, or equal.

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

7 Unilateral. Being of, or pertaining to, one side of the body.

Usual and Customary Charge. The lowest price that an eligible provider charges to any payer in Massachusetts other than for publicly aided individuals for the same equipment or item, including but not limited to the shelf price, sale price, or advertised price.

Wrist-hand Orthosis (WHO). Orthosis that traverses the wrist and hand. Sometimes referred to as wrist orthosis (WO).

334.03 General Rate Provisions

334.03: General Rate Provisions

(1) General Rate Provisions for the Purchase of Prostheses, Prosthetic Devices, and Orthotic Devices. Payment to a provider of prosthetic or orthotic devices or services are the lower of: (a) the provider's usual and customary charge; or (b) the rates set forth in 101 CMR 334.03(10) or any applicable administrative bulletin.

(2) Rates for New Codes. New codes that have established Medicare fees as of the date of the Administrative Bulletin will have rates established at: (a) 94.00% of the corresponding Medicare fee for any item described as being custom fabricated; or (b) 82.00% of the corresponding Medicare fee for any item described as being prefabricated; or (c) 70.76% of the corresponding Medicare fee for any item described as being off-the-shelf. When Medicare fees are not available for new codes, and for certain orthotics and prosthetics, rates will be established at individual consideration at adjusted acquisition cost plus the standard markup as defined in 101 CMR 334.03(9).

(3) Effect of Rates. The rates of payment contained in 101 CMR 334.00 are maximum allowable rates that a governmental unit or purchaser under M.G.L. c. 152 may pay for prostheses, prosthetic devices, or orthotic devices. A governmental unit may pay less than the rates established for a provider under 101 CMR 334.00 provided that any such discount or reduction in charge by the provider is equally available to all governmental units purchasing prostheses, prosthetic devices and orthotic devices from the provider. No rate of payment under 101 CMR 334.00 may exceed the provider's usual and customary charge for the same or similar device.

(4) Terms and Warranties. All terms and warranties, expressed and implied, that are customarily extended by the provider or manufacturer must apply to purchases made under 101 CMR 334.00. A purchaser will not pay for replacement or repair of any item or service covered by such terms or warranties.

(5) Repairs. For repair services providers must maintain and submit adequate documentation on the repair performed as indicated by the purchasing governmental unit. Repair may be billed using codes for the labor component (L7520 for prosthetics or L4205 for orthotic devices) and the parts used in the repair (L7510 for prosthetics or L4210 for orthotic devices).

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

8 (6) Modifiers. The following list of letter modifiers must be added, where appropriate, to Healthcare Common Procedure Coding System (HCPCS) procedure codes to determine the percent fee to be paid on claims. Refer to purchasers' manuals for specific coding instructions. (a) Informational modifiers:

1. LT – Left
2. RT – Right
3. CG – Policy Criteria Applied (b) Additional modifiers used for MassHealth reimbursement when using the following miscellaneous codes, L0999, L1499, L2999, L3999, L5999, L7499, and L8499:
4. U1 – AAC 40% Off the Shelf (used for not otherwise classified (NOC) codes only – identified in 334.03(10)
5. U2 – AAC 50% Prefabricated (used for NOC codes only – identified in 334.03(10)
6. U3 – AAC 70% Custom (used for NOC codes only – identified in 334.03(10)

(7) Recall Provisions. Whenever an orthotic or prosthetic is subject to recall, the provider will fully address the recall as specified in the manufacturer’s recall instructions. For recalls of potentially dangerous or defective orthotic or prosthetic that predictably could cause serious health problems, including death, the provider must provide the publicly aided individual with a copy of the recall notice and fully address the recall as specified in the recall instructions no later than five business days from the date the provider receives the recall notice. Any costs not covered by the manufacturer or other third party for activity associated with amelioration, repair or replacement of recalled equipment is included in the general rate provision.

(8) AAC Methodology and Documentation. (a) Except where otherwise stipulated in 101 CMR 334.03, payment to an eligible provider is for the AAC as defined in 101 CMR 334.02, plus a standard markup. (b) The eligible provider must accurately indicate the amount of any discounts set forth in the definition of AAC at 101 CMR 334.02. The provider must maintain documentation evidencing the amount and application of discounts. (c) Current Catalogue Price. The AAC to the eligible provider will not exceed the manufacturer's current catalogue price. (d) Where the manufacturer is the provider, the AAC cannot exceed the actual cost of raw materials. Low-cost items (those with an AAC less than $5.00) may be grouped together and billed at $5.00 plus the mark-up listed in 101 CMR 334.03(9).

(9) Individual Consideration. Except where otherwise stipulated in 101 CMR 334.03, payment to an eligible provider for individual consideration will be the lower of: (a) the eligible provider’s usual and customary charge; or (b) the AAC to the provider, plus a markup not to exceed:

1. 70% for any item described as being custom fabricated; or
2. 50% for any item described as being prefabricated; or
3. 40% for any item described as being off-the-shelf; or (c) Such schedule of allowable fees as may be issued as an amendment or revision to 101 CMR 334.00.

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

9 (10) Payment Rates. For code descriptions, see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic-devices-and-orthotic-devices

Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) A5500 $79.50

A5501 $238.41

A5503 $40.48

A5504 $40.48

A5505 $40.48

A5506 $40.48

A5507 $40.48

A5508 AAC + 70%

A5510 AAC + 50%

A5512 $32.42

A5513 $48.38

A5514 $48.38

A6515 AAC+ 70%

A6516 AAC+ 70%

A6517 AAC+ 70%

A6518 AAC+ 70%

A6519 AAC+ 40%

A6520 $84.59

A6521 $445.87

A6522 $205.54

A6523 $647.82

A6524 $256.43

A6525 $687.70

A6526 $463.61

A6527 $1,132.51

A6528 $445.79

A6529 $935.77

A6530 $49.64

A6531 $47.17

A6532 $66.48

A6533 $85.10

A6534 $85.10

A6535 $73.77

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

10 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) A6536 $94.57

A6537 $94.57

A6538 $94.57

A6539 $191.49

A6540 $80.39

A6541 $191.49

A6544 $28.36

A6545 $84.23

A6549 AAC + 50% A6552 $38.78

A6553 $201.17

A6554 $53.32

A6555 $201.17

A6556 $275.69

A6557 $275.69

A6558 $284.51

A6559 AAC + 70%

A6560 AAC + 70%

A6561 AAC + 70%

A6562 $902.29

A6563 $902.29

A6564 $971.96

A6565 $155.91

A6566 $170.41

A6567 $711.28

A6568 $111.21

A6569 $841.30

A6570 $75.78

A6571 $605.01

A6572 $70.31

A6573 $221.65

A6574 $282.57

A6575 $68.93

A6576 $173.43

A6577 $143.54

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

11 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) A6578 $53.21

A6579 $278.37

A6580 $276.32

A6581 $48.82

A6582 $32.56

A6583 $107.12 A6584 AAC + 40%

A6585 $126.83 A6586 $373.66 A6587 $48.94 A6588 $163.13 A6589 $64.40

A6593 AAC + 40%

A6594 $23.45

A6595 $23.06

A6596 $0.12

A6597 $1.04

A6598 $0.50

A6599 $1.14

A6600 $2.05

A6601 $2.31

A6602 $3.37

A6603 $1.58

A6604 $0.92

A6605 $1.05

A6606 $3.13

A6607 $0.83

A6608 $3.48

A6609 AAC + 40%

A6610 $201.17

A6611 AAC+ 70%

A8000 $167.25

A8001 $167.25

A8002 AAC + 70%

A8003 AAC + 70%

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

12 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) A8004 AAC + 40%

A9283 AAC + 40%

A9285 AAC + 40%

K0672 $77.82

K1007 AAC + 70%

L0112 $1,472.63

L0113 $261.74

L0120 $20.14

L0130 $171.62

L0140 $72.77

L0150 $124.26

L0160 $183.61

L0170 $828.94

L0172 $111.63

L0174 $322.06

L0180 $434.40

L0190 $526.44

L0200 $493.70

L0220 $134.08

L0450CG $176.59

L0452 AAC + 70%

L0454CG $366.51

L0455 $203.81

L0456 $1,046.46

L0457 $584.47

L0458 $818.56

L0460 $1,056.17

L0462 $1,146.01

L0464 $1,364.30

L0466 $434.47

L0467 $233.32

L0468 $489.73

L0469 $346.23

L0470 $695.52

L0472 $423.77

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

13 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L0480 $1,678.68

L0482 $1,751.64

L0484 $2,388.39

L0486 $2,533.96

L0488 $921.34

L0490 $259.65

L0491 $704.90

L0492 $463.87

L0621CG $95.41

L0622 $347.20

L0623 AAC + 50%

L0624 AAC + 70%

L0625CG $50.77

L0626 $71.53

L0627 $377.30

L0628CG $77.35

L0629 AAC + 70%

L0630 $148.65

L0631 $942.24

L0632 AAC + 70%

L0633 $263.20

L0634 AAC + 70%

L0635 $860.03

L0636 $1,588.01

L0637 $1,074.72

L0638 $1,387.69

L0639 $1,074.72

L0640 $1,101.01

L0641 $53.09

L0642 $279.98

L0643 $95.19

L0648 $699.21

L0649 $168.54

L0650 $694.79

L0651 $805.16

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

14 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L0700 $2,264.04

L0710 $2,442.73

L0720 $1,889.76

L0810 $3,408.91

L0820 $2,903.06

L0830 $3,775.52

L0859 $1,304.52

L0861 $197.83

L0970 $100.50

L0972 $90.50

L0974 $198.36

L0976 $150.29

L0978 $182.02

L0980 $20.48

L0982 $19.09

L0984 $60.14

L0999 U1 AAC + 40%

L0999 U2 AAC + 50%

L0999 U3 AAC + 70%

L1000 $2,593.50

L1001 AAC + 50%

L1005 $2,937.69

L1006 $1,027.74

L1007 AAC+ 70%

L1010 $74.66

L1020 $87.13

L1025 $134.98

L1030 $64.12

L1040 $78.63

L1050 $83.92

L1060 $100.23

L1070 $90.70

L1080 $59.39

L1085 $155.16

L1090 $92.39

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

15 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L1100 $194.97

L1110 $303.81

L1120 $40.03

L1200 $1,874.70

L1210 $263.75

L1220 $223.31

L1230 $644.28

L1240 $85.08

L1250 $85.03

L1260 $85.08

L1270 $85.08

L1280 $115.94

L1290 $85.08

L1300 $1,791.08

L1310 $1,927.64

L1320 AAC + 70%

L1499 U1 AAC + 40%

L1499 U2 AAC + 50%

L1499 U3 AAC + 70%

L1600 $156.08

L1610 $41.72

L1620 $158.89

L1630 $227.73

L1640 $620.14

L1650 $269.27

L1652 $327.17 L1653 $289.66

L1660 $185.00

L1680 $1,228.13

L1681 $1,768.59

L1685 $1,598.62

L1686 $884.30

L1690 $1,774.87

L1700 $1,955.97

L1710 $2,402.52

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

16 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L1720 $1,358.65

L1730 $1,428.41

L1755 $2,127.81

L1810 $104.20

L1812 $61.25

L1820 $133.85 L1821 $118.50

L1830 $54.12

L1831 $270.14

L1832 $697.99

L1833 $420.86

L1834 $1,043.26

L1836 $92.10

L1840 $983.21

L1843 $823.54

L1844 $1,721.52

L1845 $765.77

L1846 $1,306.54

L1847 $527.92

L1848 $455.55

L1850 $189.35

L1851 $534.42

L1852 $505.54

L1860 $1,143.56

L1900 $320.15

L1902 $80.85

L1904 $631.98

L1906 $118.42

L1907 $592.04

L1910 $278.78

L1920 $468.35

L1930 $240.06

L1932 $819.04 L1933 $742.56

L1940 $664.66

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

17 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L1945 $1,244.09

L1950 $961.29

L1951 $770.82 L1952 $698.84

L1960 $744.94

L1970 $956.32

L1971 $430.21 L1980 $478.53

L1990 $569.28

L2000 $1,160.64

L2005 $4,311.44

L2006 $35,630.23

L2010 $1,054.93

L2020 $1,503.49

L2030 $1,214.08

L2034 $2,114.58

L2035 $161.71

L2036 $2,493.47

L2037 $2,238.49

L2038 $1,921.50

L2040 $228.81

L2050 $640.21

L2060 $651.69

L2070 $157.31

L2080 $483.40

L2090 $464.57

L2106 $913.78

L2108 $1,388.14

L2112 $497.06

L2114 $600.35

L2116 $771.01

L2126 $1,447.41

L2128 $2,304.52

L2132 $742.76

L2134 $1,045.57

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

18 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L2136 $1,168.68

L2180 $121.47

L2182 $123.13

L2184 $129.26

L2186 $156.01

L2188 $330.39

L2190 $102.39

L2192 $378.71

L2200 $47.92

L2210 $67.76

L2220 $82.54

L2230 $77.34

L2232 $104.72

L2240 $103.72

L2250 $358.16

L2260 $202.05

L2265 $158.28

L2270 $63.30

L2275 $132.71

L2280 $503.60

L2300 $271.39

L2310 $124.00

L2320 $254.22

L2330 $442.90

L2335 $302.57

L2340 $450.50

L2350 $898.15

L2360 $52.15

L2370 $258.75

L2375 $122.01

L2380 $124.09

L2385 $172.10

L2387 $222.41

L2390 $147.12

L2395 $210.28

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

19 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L2397 $108.41

L2405 $91.73

L2415 $127.79

L2425 $150.81

L2430 $150.81

L2492 $119.58

L2500 $423.99

L2510 $815.37

L2520 $600.62

L2525 $1,638.27

L2526 $890.29

L2530 $268.61

L2540 $568.20

L2550 $289.49

L2570 $480.11

L2580 $521.97

L2600 $207.02

L2610 $244.79

L2620 $359.34

L2622 $411.94

L2624 $333.78

L2627 $2,303.94

L2628 $1,969.34

L2630 $309.48

L2640 $443.58

L2650 $121.29

L2660 $250.16

L2670 $171.94

L2680 $157.73

L2750 $112.33

L2755 $137.44

L2760 $61.24

L2768 $137.07

L2780 $90.95

L2785 $34.55

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

20 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L2795 $114.20

L2800 $143.36

L2810 $104.97

L2820 $116.24

L2830 $126.26

L2840 $38.54

L2850 $69.70

L2999 U1 AAC + 40%

L2999 U2 AAC + 50%

L2999 U3 AAC + 70%

L3000 $330.51

L3001 $139.17

L3002 $169.93

L3003 $183.37

L3010 $183.37

L3020 $208.74

L3030 $80.30

L3031 $128.87

L3040 $43.19

L3050 $43.19

L3060 $67.68

L3070 $29.16

L3080 $29.16

L3090 $37.37

L3100 $34.24

L3140 $81.73

L3150 $74.71

L3160 AAC + 50%

L3161 AAC + 50%

L3170 $40.30

L3201 $73.33

L3202 $64.17

L3203 $77.38

L3204 AAC + 50%

L3206 AAC + 50%

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

21 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L3207 AAC + 50%

L3208 AAC + 50%

L3209 AAC + 50%

L3211 AAC + 50%

L3212 AAC + 50%

L3213 AAC + 50%

L3214 AAC + 50%

L3215 AAC + 50%

L3216 AAC + 50%

L3217 AAC + 50%

L3219 AAC + 50%

L3221 AAC + 50%

L3222 $146.67

L3224 $75.13

L3225 $90.92

L3230 AAC + 70%

L3250 $460.51

L3251 AAC + 70%

L3252 $467.17

L3253 AAC + 50%

L3254 AAC + 70%

L3255 AAC + 70%

L3257 AAC + 70%

L3260 AAC + 70%

L3265 AAC + 50%

L3300 $54.86

L3310 $85.64

L3320 $70.92

L3330 $595.47

L3332 $77.59

L3334 $40.16

L3340 $89.69

L3350 $24.10

L3360 $37.47

L3370 $52.15

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

22 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L3380 $52.15

L3390 $52.15

L3400 $42.84

L3410 $97.68

L3420 $57.56

L3430 $168.61

L3440 $80.30

L3450 $111.09

L3455 $42.84

L3460 $36.10

L3465 $61.54

L3470 $65.56

L3480 $65.56

L3485 $21.27

L3500 $30.78

L3510 $30.78

L3520 $33.43

L3530 $33.43

L3540 $53.54

L3550 $9.34

L3560 $24.10

L3570 $89.69

L3580 $68.24

L3590 $56.20

L3595 $44.14

L3600 $80.30

L3610 $105.71

L3620 $80.30

L3630 $105.71

L3640 $45.49

L3649 AAC + 70%

L3650 $63.24

L3660 $117.92

L3670 $97.29

L3671 $862.84

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

23 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L3674 $1,131.86

L3675 $168.04

L3677 AAC + 50%

L3678 AAC + 40%

L3702 $276.49

L3710 $133.57

L3720 $645.15

L3730 $1,185.52

L3740 $1,405.54

L3760 $417.72

L3761 $417.72

L3762 $90.22

L3763 $696.74

L3764 $910.47

L3765 $1,227.82

L3766 $1,300.17

L3806 $434.99

L3807 $208.88

L3808 $404.52

L3809 $208.88

L3900 $1,283.23

L3901 $1,585.08

L3904 $3,039.43

L3905 $949.63

L3906 $462.71

L3908 $68.73

L3912 $81.60

L3913 $259.35

L3915 $444.02

L3916 $444.02

L3917 $88.28

L3918 $88.28

L3919 $259.35

L3921 $307.58

L3923 $99.79

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

24 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L3924 $99.79

L3925 $44.90

L3927 $29.18

L3929 $67.26

L3930 $67.26

L3931 $177.58

L3933 $204.28

L3935 $211.53

L3956 AAC + 50%

L3960 $751.31

L3961 $1,403.42

L3962 $823.14

L3967 $1,899.46

L3971 $1,803.04

L3973 $1,899.46

L3975 $1,608.80

L3976 $1,608.80

L3977 $1,803.04

L3978 $1,899.46

L3980 $354.67

L3981 $840.80

L3982 $373.81

L3984 $371.86

L3995 $37.52

L3999 U1 AAC + 40%

L3999 U2 AAC + 50%

L3999 U3 AAC + 70%

L4000 $1,540.53

L4002 AAC + 70%

L4010 $676.46

L4020 $876.97

L4030 $508.91

L4040 $450.48

L4045 $440.86

L4050 $506.83

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

25 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L4055 $359.29

L4060 $335.50

L4070 $317.57

L4080 $135.94

L4090 $105.90

L4100 $118.99

L4110 $102.27

L4130 $500.08

L4205 $22.86

L4210 AAC + 70%

L4350 $91.31

L4360 $324.62

L4361 $324.62

L4370 $221.33

L4386 $145.51

L4387 $125.56

L4392 $22.55

L4394 $16.47

L4396 $160.91

L4397 $138.85

L4398 $74.08

L4631 $1,725.88

L5000 $542.58

L5010 $1,315.14

L5020 $2,237.48

L5050 $2,925.61

L5060 $2,966.02

L5100 $2,999.95

L5105 $4,569.22

L5150 $3,857.52

L5160 $4,523.68

L5200 $4,498.53

L5210 $2,832.68

L5220 $3,040.23

L5230 $4,286.17

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

26 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L5250 $5,983.14

L5270 $6,423.67

L5280 $6,434.58

L5301 $2,634.23

L5312 $3,542.14

L5321 $3,716.15

L5331 $5,537.58

L5341 $5,427.27

L5400 $1,292.43

L5410 $493.53

L5420 $1,632.29

L5430 $565.38

L5450 $437.49

L5460 $643.25

L5500 $1,570.76

L5505 $2,198.75

L5510 $1,958.30

L5520 $2,051.00

L5530 $2,235.01

L5535 $2,033.91

L5540 $2,216.92

L5560 $2,111.42

L5570 $2,546.41

L5580 $2,640.91

L5585 $2,578.76

L5590 $2,978.07

L5595 $5,310.67

L5600 $6,279.68

L5610 $2,656.61

L5611 $2,306.91

L5613 $3,508.95

L5614 $1,778.94

L5615 $8,137.81

L5616 $1,646.51

L5617 $619.62

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

27 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L5618 $402.69

L5620 $398.07

L5622 $485.27

L5624 $520.54

L5626 $619.91

L5628 $587.35

L5629 $455.03

L5630 $548.80

L5631 $629.11

L5632 $271.76

L5634 $424.99

L5636 $364.82

L5637 $357.17

L5638 $522.60

L5639 $1,605.32

L5640 $686.66

L5642 $665.33

L5643 $2,228.54

L5644 $832.28

L5645 $954.27

L5646 $784.51

L5647 $1,138.96

L5648 $707.00

L5649 $2,044.57

L5650 $524.25

L5651 $1,719.50

L5652 $578.50

L5653 $654.48

L5654 $474.86

L5655 $338.99

L5656 $402.21

L5657 AAC+ 40%

L5658 $454.03

L5661 $871.33

L5665 $733.12

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

28 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L5666 $91.75

L5668 $133.04

L5670 $309.50

L5671 $534.16

L5672 $376.50

L5673 $847.18

L5676 $509.74

L5677 $705.96

L5678 $42.64

L5679 $705.96

L5680 $371.06

L5681 $1,386.70

L5682 $895.44

L5683 $1,386.70

L5684 $64.74

L5685 $135.03

L5686 $64.67

L5688 $76.25

L5690 $140.11

L5692 $168.76

L5694 $259.76

L5695 $197.17

L5696 $254.62

L5697 $114.94

L5698 $129.02

L5699 $259.02

L5700 $3,129.15

L5701 $3,881.97

L5702 $4,892.64

L5703 $2,538.85

L5704 $638.04

L5705 $1,169.72

L5706 $1,140.92

L5707 $1,532.83

L5710 $436.08

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

29 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L5711 $731.56

L5712 $581.28

L5714 $523.34

L5716 $940.24

L5718 $1,129.38

L5722 $1,059.62

L5724 $1,949.13

L5726 $2,421.29

L5728 $3,407.01

L5780 $1,310.33

L5781 $4,218.07

L5782 $4,446.79

L5783 $2,834.96

L5785 $743.91

L5790 $1,029.51

L5795 $1,537.32

L5810 $697.09

L5811 $1,044.25

L5812 $789.97

L5814 $3,915.16

L5816 $984.77

L5818 $1,375.00

L5822 $2,438.25

L5824 $1,913.41

L5826 $3,348.20

L5827 $7,424.27

L5828 $4,043.36

L5830 $2,716.93

L5840 $3,978.32

L5841 $3,178.01

L5845 $1,889.54

L5848 $1,133.62

L5850 $137.37

L5855 $331.64

L5856 $25,595.62

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

30 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L5857 $9,268.37

L5858 $19,592.72

L5859 $11,514.22

L5910 $518.57

L5920 $759.72

L5925 $360.83

L5926 $762.69

L5930 $3,727.46

L5940 $538.66

L5950 $1,049.03

L5960 $1,153.87

L5961 $4,901.22

L5962 $631.21

L5964 $1,143.58

L5966 $1,473.11

L5968 $3,830.93

L5969 $14,203.36

L5970 $290.79

L5971 $290.79

L5972 $441.17

L5973 $18,495.80

L5974 $326.25

L5975 $488.72

L5976 $737.86

L5978 $398.85

L5979 $2,543.48

L5980 $4,674.05

L5981 $3,480.96

L5982 $824.28

L5984 $743.36

L5985 $312.71

L5986 $696.57

L5987 $7,583.69

L5988 $2,106.01

L5990 $1,912.58

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

31 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L5991 $7,761.83

L5999 U1 AAC + 40%

L5999 U2 AAC + 50%

L5999 U3 AAC + 70%

L6000 $1,426.84

L6010 $1,587.83

L6020 $1,480.40

L6026 $4,543.03

L6028 AAC+ 70%

L6029 AAC+ 70%

L6030 AAC+ 70%

L6031 AAC+ 70%

L6032 AAC+ 70%

L6033 AAC+ 70%

L6034 AAC+ 70%

L6035 AAC+ 70%

L6036 AAC+ 70%

L6037 AAC+ 70%

L6038 AAC+ 70%

L6039 AAC+ 70%

L6050 $2,259.92

L6055 $3,567.70

L6100 $2,274.11

L6110 $2,270.25

L6120 $2,868.95

L6130 $3,117.94

L6200 $3,569.39

L6205 $4,947.99

L6250 $2,958.43

L6300 $5,331.17

L6310 $3,258.75

L6320 $1,843.60

L6350 $4,206.25

L6360 $3,420.45

L6370 $2,249.89

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

32 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L6380 $1,259.88

L6382 $1,641.98

L6384 $2,047.44

L6386 $485.69

L6388 $629.46

L6400 $2,491.79

L6450 $4,335.92

L6500 $3,737.44

L6550 $4,395.15

L6570 $5,969.55

L6580 $1,741.88

L6582 $1,541.44

L6584 $2,549.35

L6586 $2,228.51

L6588 $3,748.15

L6590 $3,309.05

L6600 $201.43

L6605 $198.89

L6610 $178.79

L6611 $434.06

L6615 $186.55

L6616 $67.25

L6620 $345.95

L6621 $2,411.30

L6623 $757.48

L6624 $3,970.28

L6625 $761.51

L6628 $610.86

L6629 $162.24

L6630 $308.58

L6632 $74.98

L6635 $193.52

L6637 $525.75

L6638 $2,636.31

L6640 $300.80

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

33 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L6641 $204.17

L6642 $285.60

L6645 $342.81

L6646 $3,324.98

L6647 $547.38

L6648 $3,429.23

L6650 $396.37

L6655 $88.28

L6660 $125.04

L6665 $60.14

L6670 $54.99

L6672 $181.07

L6675 $171.95

L6676 $136.22

L6677 $312.73

L6680 $253.53

L6682 $308.50

L6684 $461.37

L6686 $845.30

L6687 $619.41

L6688 $601.20

L6689 $739.37

L6690 $775.42

L6692 $668.72 L6691 $494.24

L6693 $2,992.91

L6694 $847.18

L6695 $705.96

L6696 $1,386.70

L6697 $1,386.70

L6698 $534.16 L6700 $27,195.67

L6703 $415.51

L6704 $628.90

L6706 $429.50

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

34 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L6707 $1,546.96

L6708 $930.54

L6709 $1,301.03

L6711 $618.27

L6712 $1,138.37

L6713 $1,436.76

L6714 $1,216.91

L6715 $3,328.28

L6721 $2,162.92

L6722 $1,864.61

L6805 $388.31

L6810 $200.51

L6880 $25,187.74

L6881 $4,309.88

L6882 $3,269.24

L6883 $1,704.09

L6884 $2,418.11

L6885 $3,420.45

L6890 $176.19

L6895 $799.51

L6900 $1,622.04

L6905 $1,576.66

L6910 $1,535.99

L6915 $721.72

L6920 $8,190.34

L6925 $9,522.22

L6930 $7,985.51

L6935 $9,296.88

L6940 $10,192.40

L6945 $11,601.32

L6950 $10,716.32

L6955 $12,974.04

L6960 $14,300.88

L6965 $16,853.00

L6970 $17,960.63

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

35 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L6975 $20,243.74

L7007 $3,893.14

L7008 $6,578.20

L7009 $4,081.25

L7040 $3,120.07

L7045 $1,735.72

L7170 $6,357.81

L7180 $40,421.00

L7181 $42,240.23

L7185 $6,622.39

L7186 $10,450.86

L7190 $8,875.04

L7191 $11,002.10

L7259 $4,528.70

L7360 $289.11

L7362 $298.81

L7364 $540.69

L7366 $736.07

L7367 $410.43

L7368 $532.05

L7400 $323.11

L7401 $361.72

L7402 $390.64

L7403 $388.21

L7404 $585.96

L7405 $766.34

L7406 $2,903.00

L7499 U1 AAC + 40%

L7499 U2 AAC + 50%

L7499 U3 AAC + 70%

L7510 AAC + 70%

L7520 $31.88

L7600 AAC + 40%

L7700 $117.41

L7900 $557.55

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

36 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L7902 AAC + 70%

L8000 $34.83

L8001 $115.37

L8002 $151.71

L8015 $55.13

L8020 $187.93

L8030 $340.04

L8031 $340.04

L8032 $31.09

L8033 AAC + 70%

L8035 $3,862.24

L8039 AAC + 50%

L8300 $79.02

L8310 $124.76

L8320 $66.32

L8330 $61.66

L8400 $16.79

L8410 $25.87

L8415 $26.77

L8417 $69.06

L8420 $19.48

L8430 $22.81

L8435 $25.42

L8440 $44.06

L8460 $71.83

L8465 $55.04

L8470 $6.25

L8480 $10.92

L8485 $10.95

L8499 U1 AAC + 40%

L8499 U2 AAC + 50%

L8499 U3 AAC + 70%

L8600 $590.06

L8603 $353.98

L8604 AAC + 40%

Final Adoption Date Published in Mass. Register: June 19, 2026

101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

101 CMR 334.00: RATES FOR PROSTHESES, PROSTHETIC DEVICES, AND ORTHOTIC DEVICES

37 Code Rate Description (see the O&P service code spreadsheet at www.mass.gov/regulations/101-CMR-33400-prostheses-prosthetic- devices-and-orthotic-devices) L8605 $568.39

L8606 $173.97

L8609 $5,991.81

L8610 $548.31

L8612 $672.13

L8613 $292.68

L8614 $17,935.61

L8701 AAC + 70%

L8702 AAC + 70%

L8720 AAC + 50%

L8721 AAC + 50%

S1040 $1,848.89

334.04 Reporting Requirements

334.04: Reporting Requirements

(1) Required Reports. All providers must comply with the requirements of 957 CMR 6.00: Cost Reporting Requirements.

(2) Penalty for Noncompliance. The purchasing governmental unit may impose a penalty in the amount of up to 15% of its payments to any provider that fails to submit required information. The purchasing governmental unit will notify the provider in advance of its intention to impose a penalty under 101 CMR 334.04(2).

334.05 Severability

334.05: Severability

The provisions of 101 CMR 334.00 are severable. If any provision of 101 CMR 334.00 or the application of any provision to an applicable individual, entity, or circumstance is held invalid or unconstitutional, that holding will not be construed to affect the validity or constitutionality of any remaining provisions of 101 CMR 334.00 or application of those provisions to applicable individuals, entities, or circumstances.

REGULATORY AUTHORITY

101 CMR 334.00: M.G.L. c. 118E.