US · guidance
CMS Pub. 100-04, ch. 20, § 10.1.2
Prosthetic Devices - Coverage Definition
Prosthetic devices (other than dental) are covered under Part B as a medical or other
health service (§1861(s)(8) of the Act) and are devices that replace all or part of an
internal body organ or replace all or part of the function of a permanently inoperative or
malfunctioning internal body organ. Replacements or repairs of such devices are covered
when furnished incident to physicians' services or on a physician's orders.
For detailed coverage requirements (including definitions and discussion) associated with
the following prosthetic device terms and circumstances see the Medicare Benefit Policy
Manual, Chapter 15:
• "Test of Permanence"
• "Prosthetic Lenses"
• "Intraocular Lenses (IOLs)"
• "Supplies, Adjustments, Repairs and Replacements"
For coverage information on specific situations and prosthetic devices, see the Medicare
National Coverage Determinations Manual.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
c3ce28afdb7dec21d30fab9d2a3434f691974ddbe17f5633a867461c2bd12370
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