Rates for Orthotics Provided to Medicare Patients – Member Input Needed
The Centers for Medicare & Medicaid Services (CMS) has drafted a list of orthotics that initially identifies specific Healthcare Common Procedure Coding System (HCPCS) codes that are considered Off-The-Shelf (OTS) orthotics. See http://www.cms.gov/DMEPOSFeeSched/04_OTS_Orthotics.asp for CMS’ list (available in a zip file under the "Downloads" section at the bottom of the page). These items would be paid to occupational therapists (OTs) at the competitive bidding rate, which we expect to be lower than present rates. Note that OTs are exempt from competitive bidding and can continue to supply these items under the OT plan of treatment without submitting bids.
Please let AOTA know of any items that you would not consider off-the-shelf and provide examples of why and what type of professional intervention is needed for each item you would take off the list. We need your input by Tuesday March 13. You may email your response to AOTA's Reimbursement and Regulatory Policy Department at email@example.com.