AAPM&R Helps Defeat Medicare Lower Limb Prostheses LCD

Members & Publications


November 11, 2015

Thanks to the dedication and persistence of Academy members, staff, and the broader community of rehabilitation professionals and individuals with disabilities, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) will not finalize the draft Lower Limb Prostheses Local Coverage Determination (LCD) (DL33787) at this time.

The LCD would have adversely affected Medicare beneficiaries' access to needed lower limb prostheses. In August, your Academy submitted comments to CMS and also provided a template letter for members to submit their own comments opposing this LCD. 
In lieu of issuing the proposed LCD in final form, CMS is convening a multidisciplinary Lower Limb Prostheses Interagency Workgroup in 2016. The purpose of the Workgroup is to develop a consensus statement that informs Medicare policy by reviewing the available clinical evidence that defines best practices in the care of beneficiaries who require lower limb prostheses. 
Many thanks to the more than 100 member physiatrists who submitted their comments and concerns to enact this change and special thanks to Marlís González-Fernández, MD, PhD, of Johns Hopkins and an AAPM&R Leadership Fellow, who testified on AAPM&R's behalf at the CMS hearing in Baltimore on August 26, 2015.

"As physiatrists, we work hard to ensure that the treatments and devices we prescribe are carefully selected to maximize our patient's function and ability to participate in society.  We are pleased that, for Medicare beneficiaries, coverage limitations will not be another hurdle to overcome in attaining that goal." - Dr. González-Fernández

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.