Insurance

Medicare

Medicare recently changed their coverage determination process for orthotics and prosthetics. They now require additional physician documentation to provide coverage.

Medicare also requires that the prescribing physician's records collaborate the prosthetist's findings and recommendations, and without this information will deny coverage even after the orthosis or prosthesis was provided.

To assist you, we have included below a downloadable outline of the information that Medicare requires. Please incorporate this information into your report and send us a copy, so we can begin treatment.


Custom Fit Knee Orthosis

Prefabricated Ankle Foot Orthosis

Custom Fabricated Ankle Foot Orthosis / Knee Ankle Foot Orthosis

Custom Fabricated Knee Orthosis

Custom Fit Knee Orthosis

Prefabricated Knee Orthosis (KO)

Prosthetic Documentation Requirements

Prosthetic Liner Documentation Requirements

Custom fabricated lumbo-sacral-orthosis (LSO) or thoraco-lumbo-sacral-orthosis(TLSO)

Custom fit lumbo-sacral-orthosis (LSO) or thoraco-lumbo-sacral-orthosis (TLSO)

Prefabricated Spinal Orthosis

Custom Fit Upper Extremity Orthosis / Elbow / Wrist