Medicare withdraws proposal to not to pay for custom orthotics by PTs/OTs!

On October 4, CMS withdrew its proposal from January of this year to remove the exemptions for PTs and OTs to quality standards and orthotic certification. The proposal would have required licensure in orthosis fabrication by the state or the American Board for Certification in Orthotics and Prosthetics, or the Board for Orthotist/Prosthetist Certification, or a program “approved by the HHS Secretary” in order for Medicare to reimburse for custom orthotics. This means that PTs and OTs can continue to provide and get reimbursed under Medicare for custom orthotics for the foreseeable future. PTPN and many of our members submitted comments to CMS opposing the proposal.

In withdrawing the proposal, CMS said that they “received over 5,000 public comments in response to the January 12, 2017 proposed rule. In light of the cost and time burdens that the proposed rule would create for many providers and suppliers, particularly the cost and burden for those providers and suppliers that are small businesses, and the complexity of the issues raised in the detailed public comments received, we are withdrawing the January 12, 2017 proposed rule in order to assure agency flexibility in re-examining the issues and exploring options and alternatives with stakeholders.”

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