Orthotics Medical Policy

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Foot Orthotics - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/400_499/0451.html

Note: Even under plans that exclude coverage of foot orthotics, Aetna covers rehabilitative foot orthotics that are prescribed following foot surgery or trauma when the these rehabilitative foot orthotics are medically necessary as part of their post surgical or casting care. In these instances, foot orthotics are … See more

Orthotic Devices and Shoes - Cigna

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0543_coveragepositioncriteria_orthotic_devices_shoes.pdf

Coverage Policy Coverage for orthotic devices varies across benefit plans. Please refer to the customers’ benefit plan document to determine benefit availability and the terms …

O-12-035 - Highmark

https://securecms.highmark.com/content/medpolicy/en/highmark/pa/commercial/policies/Orthotic___Prosthetic_Devices/O-12/O-12-035.html

This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each …

Durable Medical Equipment, Orthotics, Medical …

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/dme-equipment-orthotics-ostomy-medical-supplies-repairs-replacements.pdf

Community Plan Policy Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/ Replacements Medicare Advantage Coverage Summary Durable Medical …

CG-DME-22 Ankle-Foot & Knee-Ankle-Foot Orthoses

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_a053659.html

Medically Necessary: An ankle-foot orthosis (AFO) is considered medically necessary for ambulatory (i.e., able to walk, independently or with assistance) individuals …

CG-DME-20 Orthopedic Footwear - Anthem

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_a053656.html

Orthopedic footwear including shoes, inserts and modifications to shoes are utilized for the alignment, support, prevention or correction of deformities or to improve …

O-8-032 - Highmark

https://securecms.highmark.com/content/medpolicy/en/highmark/pa/commercial/policies/Orthotic___Prosthetic_Devices/O-8/O-8-032.html

Minimal self-adjustment can be performed by the individual, and does not require expertise of a certified orthotist. Off-the-shelf (OTS) orthotics are prefabricated, …

Does Medicare Cover Orthotics? What You Need to …

https://www.gohealth.com/medicare/coverages-benefits/orthotics/

A custom pair of orthotic shoes can cost between $400 and $600. Medicare beneficiaries will pay 20% of the cost after meeting their annual deductible, and Medicare …

Article - Knee Orthoses - Policy Article (A52465)

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465

For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of …

Prescription Custom Orthotics and Shoe Inserts - APMA

https://www.apma.org/orthotics

Orthotics are only manufactured after a podiatrist has conducted a complete evaluation of your feet, ankles, and legs, so the orthotic can accommodate your unique foot structure …

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