Reimbursement

• HCPCS CODE : L5657 “Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials.”
• MSRP 899$ USD
• MSRP Document : Click here

• HCPCS CODE : L5657 “Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials.”
• MSRP 999$ USD
• MSRP Document download : Click here

Overlay TT: RAMQ - 1146562 - Silicone gel flexible double socket, with attachment and pneumatic cushion

RAMQ - 1145630 - Silicone gel flexible double socket

RAMQ - Special Request War Amp - Daily living aids for adult and CHAMP Adult Program members

Overlay TF: RAMQ - Special Request War Amp - Daily living aids for adult and CHAMP Adult Program members

Ontario: Overlay TT: ADP - CLL2DTT31 - Air Cushion Socket
War Amp - Daily living aids for adult and CHAMP Adult Program members

BC:
Overlay TT & TF

PharmaCare
PharmaCare policies have been updated to include the Overlay TT and TF.
The reimbursement amount is calculated as list price + Girling Formula.

These products now fall under the following Product Identification Number (PIN): 77123530
(Use this PIN if pre-approval is required.)

For your convenience, here are the official documents: 
•PharmaCare Newsletter – Province of British Columbia 
•Prosthetic and Orthotic Policy Manual (Section 6.1.4) – Province of British Columbia


War Amps - Daily living aids for adult and CHAMP Adult Program members

Alberta:

Overlay TT & TF
AADL - P141 - Air Cushion Transfemoral
War Amp - Daily living aids for adult and CHAMP Adult Program members