The American Orthotic & Prosthetic AssociationThursday, Aug 13, 2026
The Centers for Medicare and Medicaid Services (CMS) has officially released the 2023 DMEPOS Medicare fee schedule and it has increased by 8.7%, this is larger than any annual Medicare increase in the last several decades.
Alexandria, VA (December 1, 2022) – Today, the American Orthotic and Prosthetic Association (AOPA) is pleased to announce its 2023 Board of Directors.
The Executive Committee will consist of Teri Kuffel, JD who assumes the role of President. Along with, Dave McGill who moves into the role of Immediate Past President and Mitchell Dobson, CPO, FAAOP who becomes President-Elect. Joining them are Jeff Brandt, CPO who was elected to serve as Vice President, and Rick Riley who will continue to serve as Treasurer.
Take a few minutes to get an important new update on where things stand with the Medicare O&P Patient-Centered Care Act from AOPA’s Executive Director, Eve Lee, MBA, CAE.
Several AOPA members had reported having an issue with select lower limb prosthetic claims being rejected with the remark code CO-261 (The procedure or service is inconsistent with the patient’s history). Since the claims were rejected and not denied the claim could not be appealed; it could only be fixed and resubmitted. However, there was no information or directions provided as to what was “inconsistent”, and how it could be fixed. This inability to fix/appeal the claims was also causing some members to miss their timely filing window.
AOPA, over the last several months, has been working diligently with key staff members at the DME MACs, the DME MAC Medical Directors and high-ranking CMS officials to find a reasonable solution and provide a pathway for suppliers to appeal these rejections; especially for those who may have missed their timely filing windows. The DME MAC Medical Directors recently informed AOPA that the issue has been resolved, and that they will be contacting the affected suppliers and provide them with directions on how to resubmit and/or appeal their claims.
Questions? Contact Joe McTernan at jmcternan@AOPAnet.org or Devon Bernard dbernard@AOPAnet.org .
Today marks the 32nd anniversary of the Americans with Disabilities Act (ADA), the groundbreaking U.S. civil rights legislation – signed into law on July 26th, 1990 – that prohibits discrimination and guarantees opportunity in mainstream American life for people with disabilities.
To honor the ADA and help advance inclusion – in all facets of society – for the patients we serve, AOPA is excited to announce the So Kids Can Move initiative. In partnership with the National Association for the Advancement of Orthotics & Prosthetics (NAAOP), we are launching this awareness raising, state-based policy initiative to expand access to recreational prostheses as medically necessary healthcare for children on a state-by-state basis. So Kids Can Move will expand access to the health and social benefits of physical activity for children who need appropriate, evidence-based prosthetic care to do so.
Orthotic and Prosthetic Community Calls on Congress to Improve the Lives of Those Living with Limb
Loss and Difference
Washington, DC – The American Orthotic and Prosthetic Association (AOPA), will ask Congress to act on proposals that will improve the orthotic and prosthetic (O&P) profession and the lives of the patients it serves when they convene in Washington DC this week.
During the 2022 AOPA Policy Forum (May 17 and 18), more than 100 O&P providers, patients, and stakeholders from 31 states, will urge members of Congress to support crucial legislation that will improve the lives of those living with limb loss or limb difference.
When they meet with members of Congress, O&P advocates will encourage lawmakers to support the Medicare Orthotics and Prosthetics Patient-Centered Care Act. This legislation will ensure O&P patients have access to quality care and will reduce fraud and abuse in the Medicare O&P benefit. Specifically, this legislation will fundamentally ensure that patients are receiving the best quality care by licensed, credentialed, and trained professionals, guarantee that patient care is easily accessible, and reduce fraud and abuse that carries both a patient care and financial cost.
“Although O&P is a small part of healthcare, it provides critical clinical services for millions of Americans living with limb loss and limb difference. Unfortunately, because of the way the system is designed, not only is there a big burden placed on O&P providers, but they are often not compensated or acknowledged for all the care provided to patients,” said Eve Lee AOPA’s Executive Director. “Together we will ask for common sense solutions that are focused on patients, we will ask for legislation that addresses the burdens O&P providers experience so that they can more easily provide safe, effective, patient-centered care.”
In January 2022, the Centers for Medicare and Medicaid Services (CMS) announced the expansion of the Medicare prior authorization program to include the following five spinal and knee orthosis codes, L0648, L0650, L1832, L1833, and L1851.
While the existing Medicare prior authorization program for select lower limb prosthesis codes has been very successful to date, AOPA heard significant concerns from members regarding challenges that will occur obtaining Medicare prior authorization in situations where there is an immediate need to provide an orthosis to stabilize an injured or unstable spine or knee.
This week, AOPA, in conjunction with its O&P Alliance partners, AAOP, ABC, BOC, and NAAOP, issued a joint statement on direct-to-consumer delivery models for custom orthotic and prosthetic care. The full consensus statement can be read here.
On Thursday, March 31 the DME MACs and the PDAC released a comprehensive correct coding bulletin for all Upper Extremity Prostheses (UEP). In the bulletin they stated that the correct coding of an UEP base code, and addition codes, are dependent on two main factors: the level of amputation and the prostheses’ power source.
The bulletin incorporates information from previous DME MAC/PDAC correct coding reminders, such as the one for Articulating Digits and Prosthetic Hands, but also includes additional information on the proper coding of all aspects of the UEP including: cable systems, suspension systems, and test sockets.
You may review the full UEP coding reminder here.
AOPA with the help of its Coding & Reimbursement Committee and prosthetic manufacturers is currently reviewing this bulletin to determine how it will impact our membership and will provide all appropriate comments and feedback to the DME MACs and the PDAC.
We would also appreciate you sharing your feedback and concerns with us via My O&P Community or info@AOPAnet.org.
Questions? Contact Joe McTernan at jmcternan@AOPAnet.org or Devon Bernard dbernard@AOPAnet.org.