Ankle-Foot Orthosis (AFO) and Knee-Ankle-Foot Orthosis (KAFO) are braces used to support muscles, immobilize joints, or correct the position of the foot and ankle (AFO) or of the knee, ankle and foot (KAFO). AFO and KAFO are made of several materials, such as metal, thermoplastic, or a combination of materials. AFO help treat contractures of the ankle, weakness or deformity of the foot and ankle, Charcot's arthropathy, pressure injuries or other deep wounds. KAFO help control instabilities in the knee and leg caused by broken bones and other conditions, by maintaining proper alignment and controlling motion.
A brace is a rigid or semi rigid device that:
- Supports weak or deformed body member or;
- Restricts or eliminates motion in diseased or injured part of body
A brace provides support and counterforce on foot, leg or body part that it is being used to brace.
Braces can be prefabricated or custom fitted.
- Prefabricated orthoses are manufactured in quantity without a specific person in mind.
- Custom-fabricated orthoses are individually made for a specific person starting with basic materials (i.e. plastic, metal, leather, or cloth).
Local Coverage Determination for Ankle-Foot/Knee-Ankle-Foot Orthosis (L33686) [Internet]. [cited 2017 Dec 7].
Pricing and Suppliers
Is it covered by Medicare Part B?
Medicare covers Ankle-Foot-Orthosis (AFO) and Knee-Ankle-Foot Orthosis (KAFO) for beneficiaries who have plantar flexion contracture of the ankle, plantar fasciitis or Charcot’s arthropathy, and meet specific requirements. These braces are routinely non-covered for other conditions. Medicare has guidelines that establish what is considered medically necessary and how often an item can be used.
AFO/KAFO are not covered by Medicare when used to alleviate pressure from a diabetic foot ulcer.
Local Coverage Determination for Ankle-Foot/Knee-Ankle-Foot Orthosis (L33686) [Internet]. [cited 2017 Dec 7
How can I purchase this product?
If you have coverage through Medicare Part B and your condition meets Medicare requirements for coverage, you may be eligible to have this product covered by Medicare, as long as the product has been verified to a HCPCS code and meets Medicare requirements. Please note that Medicare has very strict policies and requirements for coverage. If this product and your condition meet these requirements, you will need a written order prescribed by a provider enrolled in Medicare, so that you can purchase this product at a Durable Medical Equipment store that accepts Medicare. You will need to pay deductibles and co-payment. The actual co-payment amount varies according to your state and your Medicare plan. If you do not have Medicare Part B or do not meet the requirements needed for coverage, you can find this product at pharmacies and medical supply stores, and purchase the product "out-of-pocket". When available, please see pricing in "Other Stores".
The table below shows highest and lowest Medicare pricing across the country
|Description||Medicare DME co-payment Min / Max
|Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise||
$31.58 / $42.10
If your insurance does not cover this product, you can purchase it directly from any store. A list of online stores and prices is provided below for your convenience. For updated prices, find it on the internet at https://woundreference.com/app/product?id=878
* Indicates whether store accepts Medicare or commercial insurance, but may not apply to this specific product. See coding, coverage and reimubursement for more information.
The information on this handout is for your convenience and educational purposes only. All product claims and specifications are those of the product suppliers. It does not constitute medical advice or a guarantee for reimbursement. Prices may have changed and suppliers may not have product in stock. Please confirm accuracy and appropriateness of information with insurance carrier and product supplier. Clinician and WoundReference assume no liability for inaccuracies or misstatements about products and insurance coverage.