For patients who have suffered a loss of limb, or amputation, determination of current functional level is a vital step on the road to recovery. Proper assessment and documentation of functional level has a tremendous impact on procuring necessary prosthetic equipment, and on overall functional outcome. To help insurance companies better understand this need on a patient by patient basis, K-Levels were established by Medicare. At the Physical Medicine and Rehabilitation of Long Island, Dr. Rai can perform K-Level assessments to help patients spend less time going back and forth with their insurance company when trying to secure coverage for a prosthetic.

The Five K Levels:

As a way to demonstrate a patient’s need for prosthetic’s, medicare created tiers of necessity known as K-Levels. Dr. Rai will be able to assess which K-Level you fall into, and relay this to your insurance company:

  • Level 0: The patient’s condition will not benefit from the use of prosthetic’s.
  • Level 1: Prosthetic’s can help with a patient’s movement throughout their household.
  • Level 2: Those at this level would be able to traverse outside of their homes with prosthetic’s.  These patients typically had a moderate level of activity.  
  • Level 3: Patient’s classified at level 3 are the second most active of amputees.  With the use of prosthetic’s, they would be able to travel and exercise with moderate intensity.
  • Level 4: Allowing these patients to use prosthetic’s can lead to them moving with high levels of intensity.  Children, active adults, and athletes are commonly found in this level.

Determining K-Levels:

Depending on the K-Level you fall into, you will be more or less likely to receive medical coverage for prosthetic. Dr. Rai does not want any of our patients to have to miss out on gaining access to these vital pieces of medical equipment due to insurance issues. To properly determine what level you fall into, he will administer one of the below methods of assessment: 

  • Amputee Mobility Predictor.
  • Distance Walk Tests.
  • Timed Walk Tests.
  • Prosthesis Evaluation Questionnaire.
  • Timed Up and Go.
  • Patient Assessment Validation Evaluation Test.

At Physical Medicine and Rehabilitation of Long Island, we sympathize will of our patients that have needed to undergo amputations. If prosthetic’s are necessary to increase your quality of life, Dr. Rai can help stop any push-back you may receive from insurance companies. Contact us today so we can assess your K-Levels to get you the prosthetic’s you’re entitled to.