Many third party payors and state Medicaid agencies will pay for TheraTogs if they are requested properly “through the system” as defined by that payor. In most of those cases, the TheraTogs system must be ordered through an O&P (orthotic and prosthetic) provider or a DME (durable medical equipment) facility by TheraTogs product code. The provider will then submit an insurance funding request that includes a doctor’s prescription plus a firm, persuasive and specific LMN that’s been written by the patient’s therapist. The funding request must indicate the appropriate HCPCS billing code.
We have Authorized TheraTogs Providers all over the country who are experienced with dispensing and filing reimbursement claims for TheraTogs. Visit our Provider Locator to find the provider closest to your location.
Prescription requirements vary by state and by payor, but your provider of choice will likely know the requirements. If they need more information, have them contact Lee Taylor at firstname.lastname@example.org.
We know this can be a little challenging. We’re working diligently on some solutions that will make the reimbursement path clearer. Stay tuned!