for our patients

How is the cost for CPM covered?

CPM prescribed for a total knee replacement or revision is covered by Medicare for 21 days under the HCPC code E0935. Therapy must be initiated within 48 hours of the procedure in order to qualify for coverage. Once the patient is discharged to the home, CPM treatment is covered by Medicare Part B up to the 21st day following surgery. OrthoRehab is also contracted with hundreds of other health plans for CPM, bracing and cold therapy. Although policies may differ in their coverage, CPM is widely accepted and approved by most health and worker’s compensation plans.

How does ORI get reimbursed?

OrthoRehab is dedicated to providing reimbursement support to patients. Our team of Patient Liaisons and reimbursement specialists work with your health plan(s) to obtain timely pre-authorization of benefits and help get you the maximum benefit from your plan. Due to variances in CPM, bracing or cold therapy coverage policies, a detailed physician letter of medical necessity may be required to ensure timely payor authorization for certain post-operative indications.

Will I have any financial responsibility?

In today’s market, everyone has a co-pay, and medical equipment is no different. We always work with our patients so that they are aware of their financial responsibility as far in advance as possible. Sometimes this responsibility is a co-pay that their insurance company requires us to collect, sometimes it is a self-pay if a patient has been advised that CPM or a brace is not going to be covered by their insurance. Generally, the percentage you would need to pay will depend on the type of plan/coverage you have.

Who can I call with questions?

If you receive a bill from us and have any questions, please contact the team member listed on your bill as helping to work your reimbursement. They are going to be familiar with your case and ready to help you with any further questions you may have.