Blue Cross and Blue Shield of Texas policy
Myoelectric Prosthetic and Orthotic Components for the Upper Limb
Myoelectric Prosthetic and Orthotic Components for the Upper Limb is a public Blue Cross and Blue Shield of Texas policy (policy DME104.001, effective Jun 15, 2026). It lists 48 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Policy number
- DME104.001
- Effective
- Jun 15, 2026
- Line of business
- Commercial, Medicaid
- Source
- medicalpolicy.hcsc.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
All Blue Cross and Blue Shield of Texas policies · Blue Cross and Blue Shield of Texas prior authorization CPT list