August 2015


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Proposed Medicare Lower Limb Prosthesis Policy Will Significantly Limit Your Access to Clinically Appropriate and Medically Necessary Prosthetic Care

The proposed policy could limit your access to clinically appropriate prosthetic care through the following provisions:

  1. New amputees will be restricted to use of a basic "preparatory" prosthesis while participating in a post amputation rehabilitation program. The use of technologically advanced prosthetic components will not be permitted during this preparatory phase, forcing active amputees to utilize a prosthesis that does not meet their clinical needs.  New amputees will only be eligible for a "definitive" prosthesis after successful completion of a rehabilitation program using a basic prosthesis.
  2. New amputees will be required to have an extensive, in person, evaluation performed by their treating physician or a designated Licensed/Certified Medical Professional (LCMP) prior to the delivery of their definitive (long term) prosthesis. Additionally, before you can receive an appropriate prosthesis, a health professional would be required to certify to Medicare that you have sufficient cognitive, cardio-pulmonary, and neuro-muscular ability to ambulate with the prosthesis that was prescribed for you.   The requirement for this extensive evaluation, including documentation of conditions that may have no impact on the patient's ability to effectively use a prosthesis, will cause significant delays in the delivery of clinically appropriate prostheses.
  3. Medicare will no longer allow the potential for enhanced mobility/functional ability of patients to be considered when determining what type of prosthesis best meets their clinical need. In order to qualify for technologically advanced prosthetics, patients must be able to demonstrate their mobility/functional capabilities now, in real time, as opposed to how they can benefit from advanced technology to improve their mobility in the future.
  4. If you utilize, or if your records show that Medicare has paid for, any form of mobility aid (cane, crutches, walker, etc.) your access to higher quality prosthetic components will be severely limited, regardless of your functional capabilities. This is arbitrary and discriminatory, especially for bilateral amputees who may require an assistive device for balance purposes only.
  5. If you cannot achieve what Medicare contractors deem a "natural gait" while wearing a prosthesis you may not be eligible to receive one. This is another discriminatory action that will severely limit access to clinically appropriate prostheses.
  6. Roll-on style prosthetic liners will only be covered for patients who cannot be fit with basic socket inserts. The restriction of Medicare coverage for what has become the primary method of socket suspension as well as creating a protective interface between the residual limb and socket may result in poor clinical outcomes for patients forced to rely on outdated socket interface technology.
  7. Choice of prosthetic feet will be limited by a consolidation of high technology prosthetic foot procedure codes into a single, generic, prosthetic foot code that describes all dynamic response feet-What's available will likely be driven more by price and less by the technology or features of the prosthetic foot that uniquely enhance your mobility.
  8. Medicare will no longer cover volume management/moisture evacuation systems that are used to ensure the proper fit of the prosthesis. Coverage of these systems is especially important for amputees who experience significant volume changes in their residua l limb throughout the day.
  9. The clinical knowledge and expertise of your prosthetist will not be considered relevant in the decision as to what type of prosthesis will best meet your specific clinical needs. A the prosthetist is considered a "supplier with a vested interest in payment of a claim" they may play no role in documenting the medical necessity for the specific type of prosthesis that best meets your clinical needs.

These issues only represent the major changes that are being proposed as part of the revised policy for Medicare coverage of Lower Limb Prostheses.




Jonas Seeberg, BS, CPO
Ask the Prosthetist
Frequently...and not so frequently asked questions

Q: Jonas, I'm considering an elective amputation due to chronic pain and mobility issues after a motorcycle accident. Do you have any resources that will give me more information?

A: The Amputee Coalition has an excellent Limb Loss Resource Center. It has an entire section on Before Amputation that should answer a lot of your questions. Remember, you can always schedule an appointment to come in and speak with a prosthetist at Real Life. We are always available for pre-amputation consultations.

"Birds Eye View' of Jonas Seeberg, BS, CPO presenting Prosthetic Overview 2.0
Prosthetics for Therapists™

The purpose of our Prosthetics for Therapists™ continuing education course series is to provide continuing education credits for therapists in Maryland, Delaware and Virginia by presenting courses on various aspects of upper and lower extremity prosthetics. Cost Effective. There is no cost. You can't get more cost effective than that!


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September 9, 2015 (12:00pm - 1:00pm)

Chestertown PT/AquaFit

Course #16 Transfemoral Prosthetics 2.0


September 14, 2015 (12:00pm - 1:00pm)

Upper Chesapeake Medical Center

Course #16 Transfemoral Prosthetics 2.0 


September 15, 2015 (9:00am - 10:00am)

Johns Hopkins Bayview Medical Center

Course #16 Transfemoral Prosthetics 2.0 


September 22, 2015 (12:00pm - 1:00pm)
Harford Memorial Hospital

Course #16 Transfemoral Prosthetics 2.0

September 23, 2015 (11:00am - 12:00pm)

Christiana PT @ Springside Plaza

Course #16 Transfemoral Prosthetics 2.0 

September 29, 2015 (8:00am - 9:00am)

University of Maryland Rehabilitation & Orthopedic Institute

Course #16 Transfemoral Prosthetics 2.0



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ISPO 2015
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ISPO World Congress brought over 4,300 delegates to Lyon, France in June. The interdisciplinary program featured symposia, instructional courses, manufacturers' workshops and poster sessions. This Congress also offered P&O professionals a unique opportunity for professional development through discussion and exchange amongst teachers, clinicians, researchers, technicians, manufacturers, doctors and therapists.

Furthermore, the parallel tradeshow provided a platform for equipment manufacturers from across the globe to showcase their products as well as to exchange, network and get closer to their customers.

Educational institutions, systems and service providers, rehabilitation centers, financial institutions, etc. also got an opportunity to promote their activities to an international audience while learning, sharing, initiating new projects and building partnerships.

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