In a proposed rule published July 10 in the Federal Register, the Centers for Medicare & Medicaid Services (CMS) expanded the definition of a brace to include powered orthoses and exoskeletons, which would reverse the devices’ previous classification as durable medical equipment (DME).
Until now, the CMS position has been that powered orthoses and exoskeletons should be DME because “they generated motion across a joint without necessarily supporting a weakened joint or body member,” according to the American Orthotic and Prosthetic Association (AOPA).
“It is also important to note that although braces in the past have typically not included powered devices or devices with power features, technology has evolved to include newer technology devices with power features designed to assist with traditional bracing functions,” the CMS publication said.
“This proposed rule represents a significant development that will better classify powered orthoses and exoskeletons under the Medicare orthosis benefit category,” AOPA said in response. “AOPA will continue to communicate issues of importance to CMS officials in hopes of more favorable outcomes like this one.
The proposed rule is within a publication to establish 2024 payment rates for the Medicare Home Health Prospective Payment System, which would also create a new benefit category for compression garments used to treat lymphedema, change how Medicare fee schedules are calculated through competitive bidding, modify supplier enrollment processes to control Medicare fraud and abuse, and codify policies regarding documentation requirements for refills of Durable Medical Equipment, Prosthetics, Orthotics and Supplies items.
To read the proposed rule, visit the Federal Register.
