At TSI, we have noticed a disturbing trend in our medical community. Over the past several years, we have heard from our referring Orthopedic Surgeons that they have been told CPM is no longer covered by Medicare or commercial insurance carriers.
That simply is NOT true!!! CPM is covered by Medicare and the majority of commercial carriers too for HOME use!!
Let’s take a brief walk through history. In the recent past, say 10-15 years ago, most surgeons kept their patients in the hospital for 3-5 days to recover from Total Knee Replacement (TKR). Continuous Passive Motion (CPM) machines were often used in the hospital during those days and at home after discharge. This was common practice and considered the standard of care.
Medicare and commercial insurance would NOT pay the hospital for CPM while being used during the hospital admission. So the hospitals absorbed the cost of the CPM while patients stayed in the hospital. However, Medicare and commercial carriers WOULD pay for CPM when used at home.
Let’s move forward in time. Since early 2019, Medicare has strongly encouraged surgeons and hospitals to reduce the length of stay following Total Knee Replacement (TKR). With many patients leaving on the same day of surgery or one day after surgery, many hospital systems no longer use CPM while the patient is still admitted. That has no bearing on whether a patient can use CPM at home. The CPM is still covered for home use and the patient has the right to request CPM be prescribed for recovery at home. This is your Medicare benefit and you can ask for CPM at home.
Many surgeons have a misunderstanding that CPM is no longer covered and some have stopped prescribing CPM. AGAIN, CPM is still covered for home use as long as CPM is started within 2 days of discharge.
Arm yourself with the facts. Understand that CPM is covered by Medicare and commercial insurance and you can request CPM to be ordered by your surgeon.
We are embarking on a marketing campaign to Orthopedic Surgeons throughout Houston so that they understand the facts. But we are also educating the patient population as well. You can ASK your surgeon to order CPM, if the surgeon declines to order CPM, DEMAND MOTION and CPM from your surgeon. Most surgeons will honor your request. However, if your surgeon refuses, and you want to get on your best ROAD TO RECOVERY with CPM, we would be happy to visit with you directly about your CPM benefits and direct you to surgeons that will respect your request for CPM.