December 02, 2025
On November 17, 2025, the Oregon Division of Financial Regulation, which includes the Insurance Department, approved Permanent Administrative Order ID 9-2025: List of Prosthetic and Orthotic Devices under Oregon SB 699 (2025). The Order:
- Establishes a list of prosthetic and orthotic devices consistent with Oregon Revised Statute 743A.145, such as any device for which CMS has established an L Code in the Healthcare Common Procedure Coding System Level II as of January 1, 2026, and any additional devices determined to be medically necessary and the most appropriate model that meets the medical needs of the insured for performing physical activities and maximizes the insured’s whole-body health.
- Prohibits internal or separate limits or caps on prosthetic and orthotic devices, except for the lifetime policy maximum when permitted by law.
- Defines the circumstances under which coverage for prosthetic and orthotic devices is provided through a managed care organization.
The effective date for the Order is January 1, 2026. For official text of the Order, please see: ID 9-2025: List of Prosthetic and Orthotic Devices under Oregon SB 699 (2025).
For more background on this and other 2025 legislative changes for employee benefits in Oregon, review our prior article, Oregon Governor Signs Various Healthcare Bills into Law, in Compliance Corner.