Medicare restricts DME coverage of hand/finger orthoses

Why This Topic Matters

These updates can change whether orthotic claims are payable, noncovered, or subject to additional verification steps. The article helps billing and compliance teams understand which categories of orthoses are being reassessed and why claim processing may change.

Article Sections

1. Hand and finger orthoses coverage change

   Discusses Medicare’s revised DME coverage approach for selected hand and finger orthoses and the timing of the policy change. It also introduces the related classification and billing implications.

2. PDAC verification and contractor transition

   Covers the new product classification verification process and the contractor resources referenced for confirming coverage status. It also notes the transition from the prior DME classification resource.

3. New DME restrictions on spine orthoses

   Summarizes Medicare’s additional policy limits affecting prefabricated and custom spinal braces. The section outlines how product classification verification relates to billing eligibility for these orthoses.