Special Requirements for Therapists Who Provide Orthotics

October 2, 2017
Rick Gawenda

On January 12, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule which would specify the qualifications needed for qualified practitioners to furnish and fabricate, and qualified suppliers to fabricate prosthetics and custom- fabricated orthotics; accreditation requirements that qualified suppliers must meet in order to bill for prosthetics and custom-fabricated orthotics; requirements that an organization must meet in order to accredit qualified suppliers to bill for prosthetics and custom-fabricated orthotics; and a timeframe by which qualified practitioners and qualified suppliers must meet the applicable licensure, certification, and accreditation requirements. In addition, this rule would remove the current exemption from accreditation and quality standards for certain practitioners and suppliers.

This proposed rule, if finalized, would have a significant impact on physical therapists (PTs) and occupational therapists (OTs) who currently provide custom fabricated orthotics to their patients. Well, CMS has made their decision and the decision is

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    1. You would need to check with your insurance carriers. We estimate there are over 18,000 insurance carriers.