Reimbursement Support

Reimbursement Support

MPK Reimbursement for K2 Patients?
Could you get reimbursed for a microprocessor-controlled knee for a K2 patient? Maybe! Historically, most large commercial payers have followed Medicare guidelines when covering prosthetic devices – and Medicare only covers microprocessor knees for K3 and above. HOWEVER: some payers do have favorable K2 language in their policies and may cover microprocessor knees—such as the Compact—for high functioning K2 patients who meet the criteria stated in their Medical Coverage Policies.

If you have K2 patients in the regions covered by these payers, familiarize yourself with their medical coverage policies. It may open up a whole range of new opportunities for fitting the Compact—and provide your patients with increased stability at the same time. If you need a copy of a specific policy, contact your Otto Bock sales representative or call 800.328.4058 and ask for one of our reimbursement staff.

Note: Some plans are not obligated to use the payer’s policies (e.g. Federal Employee Plans, Employer Self-Insured, HMO, Medicare/Medicaid Managed Care plans).
11/14/2011