Deadline Looms for Prosthetics and Custom Fabricated Orthotics Therapists

Facilities have only a limited time in which to respond to a final rule from the Centers for Medicare & Medicaid Services (CMS) that seeks exemption from the durable medical equipment (DME) supplier accreditation for physical and occupational therapists who fabricate custom upper extremity orthoses.

The deadline for comment to CMS-6012-P, “Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom Fabricated Orthotics,” is March 13.

The proposed rule, while serving to eliminate the exemption from DME supplier accreditation for those who fabricate custom upper extremity orthoses would in turn require licensed physical and occupational therapists to seek additional training and certification by the American Board for Certification in Orthotics and Prosthetics, Inc. (ABC), or by the Board for Orthotist/Prosthetist Certification International (BOC). 

Occupational and physical therapists who work in upper extremity rehabilitation are certified as hand therapists (CHTs) by the American Society of Hand Therapists after completing certification requirements and testing through the Hand Therapy Certification Commission (HTCC).

According to the American Physical Therapy Association (APTA), this proposed rule “aims to tighten up requirements around who CMS will work with when it comes to making and furnishing devices ranging from glass eyes to exoskeletal systems and finger orthotics.” According to the APTA, “the most notable parts of the proposed rule have to do with how a provider would become qualified to participate in the system.” According to a fact sheet from CMS, while PTs are among the providers who could participate, they would need to be “licensed by the state (as a qualified provider of prosthetics and custom orthotics) or … certified by the American Board for Certification in Orthotics and Prosthetics … or by the Board for Orthotist/Prosthetist Certification.”

According to the HTCC, specialty certification in hand therapy recognizes “occupational therapists and physical therapists with advanced clinical knowledge, experience, and skills in the practice of hand and upper extremity rehabilitation. It assists consumers and the healthcare community in identifying those therapists who meet the rigorous standards required of CHTs, including three years of practice experience with 4,000 hours or more in direct practice in hand therapy and successful completion of a comprehensive test of advanced clinical skills and theory in upper quarter rehabilitation.”  The HTCC indicates that there are 6,228 CHTs worldwide.

CMS is accepting comments on the proposed rule through March 13, 2017. Information is available from the following therapy advocacy organizations to assist in developing a response to the CMS proposed rule:

Comments may be submitted in writing or electronically (with ease) at:  https://www.regulations.gov/document?D=CMS-2017-0004-0001 

If your facility provides upper extremity rehabilitation and fabricates custom orthoses integral to the rehabilitation process, action is required in the next few days.

Facebook
Twitter
LinkedIn

Nancy J. Beckley, MB, MBA, CHC

Nancy Beckley is founder and president of Nancy Beckley & Associates LLC, providing compliance planning and outsourced compliance services to rehab providers in hospitals, rehab agencies, and private practices. Nancy is certified in healthcare compliance by the Healthcare Compliance Certification Board. She is on the board of the National Association of Rehabilitation Providers and Agencies. She previously served on the CMS Professional Expert Technical Panel for Comprehensive Outpatient Rehabilitation Facilities. Nancy is a familiar voice on Monitor Mondays, where she serves as a senior national correspondent.

Related Stories

War and Medicare Enrollment

Combat is often described as hours of boredom intermixed with moments of sheer terror.  I fear that that metaphor is increasingly applicable to Medicare enrollment. Few

Read More

The OIG, ABN, IMM, and DND in the News

Let’s start with a recent (U.S. Department of Health and Human Services Office of Inspector General) OIG audit of a Medicare Advantage plan. Now these

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

2026 ICD-10-CM/PCS Coding Clinic Update Webcast Series

Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.

April 13, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Fourth Quarter

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

December 14, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Third Quarter

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

October 12, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Second Quarter

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s second quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

July 13, 2026

Trending News

Featured Webcasts

Compliance for the Inpatient Psychiatric Facility (IPF-PPS): Minimizing Federal Audit Findings by Strengthening Best Practices

Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.

April 9, 2026

Mastering MDM for Accurate Professional Fee Coding

In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.

March 31, 2026

The PEPPER Returns – Risk and Opportunity at Your Fingertips

Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.

March 19, 2026

Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue

Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.

January 29, 2026

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

BLOOM INTO SAVINGS! Get 25% OFF during our spring sale through March 27. Use code SPRING26 at checkout to claim this offer.

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24