In general, insurance companies rely on standardized codes to determine coverage of durable medical equipment (DME). Various models of ActivAided Rx have been PDAC approved to meet the following HCPCS codes for Lumbar Sacral Orthosis (LSO) back braces: L0637, L0650, L0631, & L0648. ActivAided Rx is therefore generally approved for coverage with a valid prescription and corresponding diagnosis.
The amount of coverage for DME supplies is very policy specific, however. You may have to meet a deductible, share in a coinsurance, or pay the initial bill and then apply for reimbursement. Insurance coverage is not a guarantee of full payment. The only way to determine the costs to you would be to call your insurance provider.
When you speak with your insurance provider, ask about your policy’s coverage for DME and approved Lumbar Sacral Orthosis (LSO) back braces. If they then ask for a specific code, you can reference the list above. Your physician and DME supplier (the company that will fill your prescription and bill insurance for you) will determine which model is best suited for your condition.
PLEASE NOTE: ActivAided Orthotics is not a licensed DME distributor and therefore does not do insurance billing directly. We work closely with medical supply companies certified for DME billing to ensure the prescription fulfillment process goes smoothly for you. By filling out this form, we can connect you with a DME supplier in your area who can provide more information about your insurance coverage for ActivAided Rx.