Saturday, April 20, 2024

New Medicare Prosthetic Coverage Requirements?

Brett R. Saunders, CPO, FAAOP

CGS Medicare has published a new Prosthetic Documentation Checklist and if I read this correctly,

Prosthetic devices can only be delivered to patients in SNF units if:

1 It will be medically necessary after discharge, AND
2 Is fit and delivered within 2 days of discharge from the SNF, AND
3 Is NOT needed for inpatient treatment or rehabilitation.

Is this a new change in policy on coverage for prosthetics??

The document I am referencing is found at cgsmedicare.com/jc/coverage/mr/PDF/MR_checklist_LLP.pdf

How could a prosthesis NOT be considered as needed for inpatient treatment and rehabilitation?

Brett R. Saunders, CPO, FAAOP

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