Most practices that offer pain management services or spine specialists as part of their overall orthopedic makeup issue OTS back braces as part of the conservative treatment plan or postoperative care provided to their surgical patients. 

Although provider preferences vary greatly on both the brace type and version offered (custom versus off the shelf), these devices contribute significantly to the overall profitability of the DME division given the high profit margins associated with the devices.

Unfortunately, many of the associated codes used to bill these braces fall under the Medicare competitive bidding program, which in most areas cut reimbursements by as much as 50%. 

A custom spine brace offering within your DME ancillary can  offset Medicare competitive bidding reductions and elevate the clinical performance of the products offered.

Although most patients that meet medical necessity only require use of an OTS device, many patients would qualify for a custom device, and thus would not be confined to the OTS option and corresponding lower reimbursement values.

New technology options make it easy to implement body scanner devices to assist in screening patient candidates, to determine if a custom appliance would be a better and more medically necessary pathway. 

Coupled with the medical history and key variables that would serve to justify the move from an OTS to a custom device (BMI, type of surgery or diagnosis, prior surgical intervention, etc.), now practices can retain those referrals and not outsource to local O & P providers.

Although key variables impact the accessibility of the platform offering (referring volume, # and type of providers in the practice, payor mix, etc.), it is certainly worth exploring and easy to assess the viability for each practice. 

Contact AMG for more information and to see if this complimentary service option is right for your practice.