On July 14, the Ontario Ministry of Health will implement some changes that may impact PBO Group clients who receive funding for orthotic devices under the Assistive Devices Program (ADP). As in the past, ADP will continue to cover 75% of device costs, and, in most cases, the remaining 25% will continue to be invoiced to the client. Here are some of the key changes that ADP-funded clients may be impacted by in the weeks and months ahead.
The Change: Some new devices and technologies will now be available for ADP funding
What This Means For PBO Group Clients:
ADP will expand its funding criteria to include not only custom-made orthotic devices but also off-the-shelf devices and those custom-made by third-party suppliers.
Examples of devices that weren’t covered in the past that now could be eligible for coverage include:
- Off-the-shelf carbon fibre ankle-foot orthoses
- Off-the-shelf supra-malleolar orthoses for children
- Custom-made third-party fabricated knee braces (e.g. Ossuc Unloader One)
Examples of devices that are still not eligible for ADP coverage include:
- Off-the-shelf knee braces
- Foot orthoses
Recommended Action: If you currently have an orthotic device that ADP does not cover, talk with your PBO Clinician to determine whether a new funding channel may be available through the ADP program.
The Change: New categories of healthcare professionals will now be able to sign forms for ADP-funded devices
What This Means For PBO Group Clients:
Physicians, including your primary care physician and many specialist physicians (such as orthopedic surgeons, physiatrists and rheumatologists), have always been able to sign ADP applications. Now, all specialist physicians, including geriatricians, neurosurgeons, pediatricians, plastic surgeons, general surgeons, radiation oncologists, and medical oncologists, as well as nurse practitioners, have authorization to sign your ADP application.
Also, specialist healthcare professionals who are registered with Ontario’s Assistive Devices Program, including occupational therapists and physiotherapists, can now prescribe devices and sign your ADP form.
Recommended Action: If an occupational therapist or physical therapist refers you for any type of orthotic device, ask them if they have ADP prescribing authority; if they do, they can sign your form and save you a trip to your doctor’s office.
The Change: ADP has updated its device codes
What This Means For PBO Group Clients:
You may notice on your invoice that the device code you’re used to seeing has been replaced with a new code, or new codes.
Recommended Action: If you have any questions about coding on your PBO Group invoice, please contact your clinic or bring your invoice to your next appointment. A member of our team will be happy to explain any changes.
