September 2014

Professional groups ask CMS to amend ‘restrictive’ custom orthotic fitting rule

By Emily Delzell

In August a number of groups, including the National Athletic Trainer’s Association (NATA), the American Orthopaedic Society of Sports Medicine, and the American Medical Society for Sports Medicine, formally called for the Centers for Medicare and Medicaid Services (CMS) to consider amending a rule proposed in July that would restrict athletic trainers, technicians, and others from fitting custom orthoses.

The End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) rule updates the definition of minimal self-adjustment of orthotic devices by defining those health professionals that have “specialized training” needed to provide custom fitting services if providers are not certified orthotists.

This would limit custom orthotic fitting to physicians, treating practitioners (physician assistants, nurse practitioners, and clinical nurse specialists), occupational therapists, and physical therapists.

NATA and others noted the rule would unnecessarily narrow the field of service providers, disrupt established physician-clinician procedures, and limit patient access to custom fitting, and asked that the “specialized training” clause be eliminated or modified.

To read NATA and other groups’ responses to CMS, go to

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