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The process of selling,
delivering, training, billing, and collecting reimbursements for the
Cybertech Back Braces, follow a similar process as with most DME products. Below,
we take you through each of the steps along with estimates for billing and
reimbursements.
Call (866) 801-6847
or
Send Inquiry
Who Qualifies?
One of the following indications must be
met:
● To reduce pain by restricting mobility of the trunk; or
● To facilitate healing following an injury to the spine or
related soft tissues; or
● To facilitate healing following a surgical procedure on the
spine or related soft tissue; or
● To otherwise support weak spinal muscles and/or a deformed
spine.
In order for a patient to qualify under
Medicare guidelines for
the Cybertech Back Brace, an Rx is required from the Doctor indicating that there is
a Medical Necessity for the patient to receive the Cybertech Back Brace. Some of the diagnosis's include:
Diagnosis |
Description |
724.2
724.0
728.87
756.12
722.10
721.3
847.2
724.9
722.52
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Lumbago
Spinal Stenosis
Muscle Weakness
Spondylolisthesis
Lumbar Disc Displacement
Lumbosacral Spondylosis
Lumbar Strains/Sprain
Spinal Disorder
Lumbar/Lumbosacral Intervertebral Disc Degeneration
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| Items qualified for If a patient
is qualified, they may receive the following items:
- 1 Cybertech Back Brace - Includes Brace &
appropriate Panels (1
unit every 5 years)
Doctors -
Prescription (Rx)
Upon patient qualification and before
placing an order, it is necessary to receive the approval from the patient's
primary
Doctor. The Prescription
Rx form is sent or faxed to the Dr. for
their signature.
Patient's authorization
to bill Medicare
The
standard patient authorization form needs to be signed by the patient and
returned prior to billing Medicare.
Billing Medicare &
Supplemental Insurance
Upon completion and certification that the
Cybertech Spine Brace has been delivered and accepted
by the patient, the Medicare Provider company then bills Medicare,
Supplemental Insurance, and possibly the patient for the co-pay amount.
Below is a schedule that shows the approximate Medicare billing amounts and
reimbursements:
The Medicare allowable for the Cybertech Back Braces varies by State with
the ranges given below.
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Cybertech - Back Braces |
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Reimbursement Analysis |
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Medicare |
Medicare |
Average |
Average |
Average |
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Allowable |
Average |
Medicare |
Dealer |
Medicare |
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Description |
HCPCS |
Range |
Allowable |
Reimb. |
Cost * |
Margin |
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Ergo Spine Brace
Flex Power Plus w/Panels |
L0627 |
$316 - $422 |
$369 |
$295 |
$105 |
$190 |
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Ergo Premium Plus
w/Panels - 8" |
L0631 |
$791 - $1,055 |
$923 |
$738 |
$205 |
$533 |
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Ergo Premium Plus
w/Panels - 10" |
L0631 |
$791 - $1,055 |
$923 |
$738 |
$215 |
$523 |
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Ergo Tri-Mod
w/Frame & Panel - 8" |
L0637 |
$904 - $1,205 |
$1,054 |
$843 |
$205 |
$638 |
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Ergo Tri-Mod
w/Frame & Panel - 10" |
L0637 |
$904 - $1,205 |
$1,054 |
$843 |
$215 |
$628 |
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* Average Dealer Cost includes shipping. |
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Certification & Training
Cybertech Back Braces - Medicare does not require any
education or certification to provide
the Cybertech Back Braces - in most states. Before selling these
products we recommend that you contact Medicare to determine if there are
any specific requirements to provide the Pre-fabricated back braces.
Call (866) 801-6847
or
Send Inquiry
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