For patients who have suffered a loss of a limb or amputation, the determination of the current functional level is a vital step on the road to recovery. Proper assessment and documentation of functional level significantly impact procuring necessary prosthetic equipment and overall functional outcome. To help insurance companies better understand this need on a patient-by-patient basis, Medicare established K-Levels. 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 to secure coverage for a prosthetic.

The Five K Levels:

Medicare created tiers of necessity known as K-Levels to demonstrate a patient’s need for prosthetics. 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 using prosthetics.
  • Level 1: prosthetics 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 prosthetics. These patients typically had a moderate level of activity.
  • Level 3: Patients classified at level 3 are the second most active amputees. With the use of prosthetics, they can travel and exercise with moderate intensity.
  • Level 4: Allowing these patients to use prosthetics can lead to them moving with high levels of intensity. Children, active adults, and athletes are commonly found at this level.

Determining K-Levels:

Depending on your K-Level, you will be more or less likely to receive medical coverage for prosthetics. Dr. Rai does not want our patients 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 with our patients who have needed to undergo amputations. If prosthetics are necessary to increase your quality of life, Dr. Rai can help stop any pushback you may receive from insurance companies. Contact us today so we can assess your K-Levels and get you the prosthetics you’re entitled to.