CMS, DME MACs Change Course after Hearing from Podiatric Medicine and Other Stakeholders


CMS and DME MACs have decided not to finalize a problematic draft LCD that could limit Medicare beneficiaries’ timely access to care. The LCD would not allow ordering physicians to refer to a podiatrist to perform “in-person functional assessments” for patients needing lower limb prostheses, such as toe fillers.

Instead, CMS will convene a multidisciplinary Lower Limb Prostheses Interagency Workgroup in 2016 to develop a consensus statement that defines best practices in the care of beneficiaries who require lower limb prostheses.

The decision to not publish the draft LCD is a victory for CPMA/APMA and a testament to their efforts in this endeavor. APMA provided written comments to the DME MACs regarding the draft LCD, and DME Workgroup Coordinator Paul Kesselman, DPM, gave oral comments at a joint DME MAC meeting in Baltimore this past August.

CPMA will provide more information about the proposed workgroup when it is available.