Medicare DME and Lumbar Braces Are Better Than Ever for Chiropractors
DURABLE MEDICAL EQUIPMENT
James Antos
Yes, it is true! Medicare reimburses many chiropractors anywhere from $375 to $1300 for providing lumbar braces to qualified Medicare enrollees, which cost the doctor $50 to $375. The average chiropractic family practice can easily have 20 or more of these Medicare patients that not only could use a durable medical equipment (DME) product such as the lumbar brace, but also truly need one.
All the chiropractor has to do is become properly registered with Medicare DME to enjoy these reimbursements. The reason more chiropractors do not participate in this program continues to escape me. I know of many offices that have had a huge net gain because of this additional income from existing patients, which is especially helpful in these times of diminishing net returns and increasing overhead and lifestyle pressures.
I know of a great number of chiropractors who do not like dealing with Medicare patients. I also know there aie chiropractic consultants who tell their clients to stay away from Medicare, advising that it is too dangerous and the income is poor.
I understand. I get that covering adjustments only is tantamount to discrimination by the Federal government. With poor reimbursement for only adjustments from Medicare on the provider-services side, many choose to focus their practices on more lucrative types of patients, such as, for example, auto accident victims.
Now is the time, more than ever, to consider adding this valuable treatment protocol to your arsenal of options in the treatment plan. Believe me, letting thousands of dollars escape from your practice every year just makes no sense at all.
Yes, as a chiropractor, you can do this.
There ai e many common questions that I get from chiropractors who aie investigating the possibility of becoming a supplier of DME (e.g., lumbar braces) and some of them aie as follows:
Question 1: I have been told that chiropractors cannot participate in the Medicare DME program. Is that true?
Answer: Wrong! Hundreds of chiropractors now aie actively participating and aie enjoying the strong reimbursements every day in their practices.
Question 2:1 have been told it is too hard and time consuming to document for Medicare. Is that true?
Answer: Not so. Documentation for Medicare DME is one of the easiest of all types of procedures and modalities to document, at least that I know of. In fact, it takes maybe one minute in the already existing notes to document lumbar brace necessity and use.
Question 3: Is it true that Medicare can ask for past reimbursements back and often does so?
Answer: Medicare does not often ask for money back, but when they do, it is for very good reasons, such as fraudulent or criminal activity. I believe that they should curtail fraud and criminal activity so that the rest of us can treat our patients the best we can and be reimbursed well for that treatment.
Question 4: Why even consider using a DME product such as a lumbar brace for a patient? I don’t do that now, and my patients do fine.
Answer: The main reason a chiropractor should consider bracing in a treatment plan is to provide support for the variety of instability syndromes that we see every day. The most common of these include but are not limited to herniated discs, bulging discs, degenerated discs, spondylosis, spondylolisthesis, osteoporosis, stenosis, prior back surgery, chronic facet syndrome, chronic muscle spasm, spinal curvature, unable to “hold” chiropractic adjustments (Medicare hates long-term repeated adjustments with no end in sight and very short-term limited results), and many others too numerous to talk about here. In fact, volumes could be written on this subject.
So now the question remains: Should I, as a chiropractor, continue to ignore the rapidly growing Medicare population as
Outcomes are better, patients are more satisfied, and Medicare is happier with the treatment plan.? J
a strong segment of my practice? These patients are imbedded in every community and need both chiropractic adjustments and DME supplies. With the valuable addition of Medicare DME to the chiropractic practice, the net profit goes from about $30 per visit to $100 to $200 per visit. Outcomes are better, patients are more satisfied, and Medicare is happier with the treatment plan.
Think about it. Why ignore such an easy, gold-standard, vanilla treatment addition to your practice?
Patients are getting these products right now, so why shouldn’t they get them from you?
Dr. Antos semes as a consultant in the areas of DME applications, documentation, and clinical appropriateness. Dr.Antos has been in private chiropractic practice since 1978 in the State of Florida. He received his Diplomate certification in 1986 in Orthopedics and has semed as a Director to the Florida Chiropractic Association Board. He currently serves as a monitor for the Department of Profession Regulation in the State of Florida and is the current Treasurer of the Flagler-Volusia Chiropractic Society. He is currently in practice in Daytona Beach, Florida. You can reach him at of. 386-212-0007 or via email [email protected]
