Privileging Changes


​​Effective January 1, 2019, the practice of privileging non-credentialed caregivers was eliminated. The ABC Board of Directors revised ABC's Orthotic, Prosthetic and Pedorthic Scope of Practice, specifically the way individuals can be privileged to provide patient care. A new definition of Support Personnel was also created allowing ABC credential holders to delegate certain non-critical patient care tasks to non-credentialed individuals. In addition, changes were made to the definitions of Direct Supervision and Supervision and Privileging of a Credential Caregiver.

Please see below for additional information.





​Privileging--What Does it Mean ​for You? ​ ​

Professionals Who Can Privilege Guidelines
Cert​ified Orthotist​​ Can privilege certified prosthetists, pedorthists, orthotic assistants and orthotic fitters in orthotics only.

Can  privilege certified therapeutic shoe fitters in pedorthics only​.
Certified Prosthetist Can privilege certified orthotists and prosthetic assistants in prosthetics only.
Certified Pedorthist Can privilege certified prosthetists, orthotic assistants, orthotic fitters and therapeutic shoe fitters in pedorthics only.
Resident/Exa​m Candidat​e No Changes on January 1, 2019—Can continue to provide supervised care.
​Professionals Who Can Be Privileged Guidelines
Certified Orthotic Assistants Can only be privileged by certified Orthotist and Pedorthist
Certified Prosthetic Assistants Can only be privileged by certified Prosthetist
Certified Orthotic Fitter Can only be privileged by certified Orthotist and Pedorthist
Certified Therapeutic Shoe Fitter Can only be privileged by certified Pedorthist and Orthotist (*Note: can only be privileged to provide services within pedorthist's scope of practice)
Certified Mastectomy Fitters New privileging rules do not apply (see Mastectomy Scope of Practice)
Certified Technicians Can only be privileged to provide repairs and minor adjustments, in the discipline they are certified
Pedorthist & Fitter Applicants obtaining required experience hours All initial patient evaluations and final fitting/deliveries must be done under [Direct Supervision]
State Licensed Individuals Most state licensure laws do NOT allow privileging (see specific state law or rules)
Off-The Shelf None—provision of off-the-shelf devices does NOT require a certified individual

*Privileging of a certified individual is done under [Indirect Supervision]​



What is privileging?
Privileging refers to giving an individual permission or ‘privileges’ to engage in specified clinical activities. ABC defines how a credentialed person may be allowed, under supervision, to provide items and services outside of their scope of practice. That privileging process is described in detail in the ABC Orthotic, Prosthetic and Pedorthic Scope of Practice​. 

Why was the ability to privilege a non-certified individual eliminated?
The ABC board of directors feels strongly that the education and training required for certification are critical elements in the provision of safe and effective patient care. We believe this change raises the standard of care and upholds the highest level of patient care services by ABC credential holders.

Are non-certified individuals allowed to provide any services?
Certain patient care tasks can be delegated to non-credentialed individuals. The new definition for Support Personnel details what aspects of patient care can be delegated to non-credentialed persons. For more information, refer to the def​inition of Support Personnel​

What are my options if I currently privilege non-certified individuals?
You should consider encouraging your non-credentialed staff to become certified as an orthotic or prosthetic assistant, an orthotic fitter or a therapeutic shoe fitter depending on what your practice needs. Non-credentialed individuals continue to be allowed to provide off-the-shelf items.​

How will this affect my accreditation?
All ABC accredited facilities will have to comply with the new standards. There will be no impact to your accreditation until that date. You should begin now to review your practice’s policies and procedures if you currently privilege non-credentialed individuals to provide patient care.

Does this change affect the accreditation standards?
Standards HR.6 and HR.6.1 have been revised to reflect the changes to the privileging rules. ​

How can I modify my current policies to meet the new standards?
If you don't currently privilege non-credentialed staff to provide patient care services you do not need to make any changes to your practice. If you are currently privileging non-credentialed staff, you need to assess what types of items/services the non-credentialed individuals are providing. If they are only providing off-the-shelf items, they can continue to provide these types of items. If they are providing any services related to custom fitted or custom fabricated items, this change will impact that ability. In order to continue to provide those services, your non-credentialed individuals will need to become certified as an orthotic or prosthetic assistant, an orthotic fitter or a therapeutic shoe fitter. You should also review the new definition of Support Personnel to determine if your practice's needs can be met within the framework of that definition.

Will current non-certified care providers be grandfathered in so that they can continue to be privileged to provide care? 
No, there are no grandfathering pathways. All ABC accredited facilities and certified individuals must comply with the changes to the Scope of Practice.

My non-certified individual is providing OTS; do they need to be privileged?
No. Off-the-shelf items can be provided by any staff member; no certification is required. Any item that has 'off-the-shelf' in the Medicare HCPCS L-code descriptor is considered an off-the-shelf item. This does not include diabetic HCPCS codes (e.g., A5500).