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This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Rule 5160-10-35 | DMEPOS: cranial remolding devices.


(A) No particular form or format is specified for the certification of medical necessity.

(B) Payment may be made only for a cranial remolding device that meets the standards established by the United States food and drug administration for a class II medical device.

(C) Payment may be made for the purchase of a cranial remolding device to treat any of the following conditions if the associated criteria are met.

(1) Positional (non-synostotic) plagiocephaly:

(a) The individual is at least three months old but not older than eighteen months;

(b) Any of the following asymmetries is present:

(i) A right/left discrepancy in the skull base of at least six millimeters, measured subnasally to the tragus;

(ii) A right/left discrepancy in the cranial vault of at least ten millimeters, measured from the frontozygomaticus point to the euryon; or

(iii) A right/left discrepancy in the orbitotragial distances of at least four millimeters; and

(c) The asymmetry has not substantially improved after two months of conservative cranial repositioning therapy or physical therapy.

(2) Positional (non-synostotic) braciocephaly: The cephalic index (the ratio of the maximum width of the head to its maximum length) is greater than ninety-one per cent.

(3) Positional (non-synostotic) scaphocephaly: The cephalic index is less than seventy-five per cent.

(4) Synostotic deformity:

(a) The individual is not older than eighteen months;

(b) Premature closing of the cranial structures has been documented; and

(c) Surgery with post-operative remolding is medically indicated.

Last updated January 2, 2024 at 9:00 AM

Supplemental Information

Authorized By: 5164.02
Amplifies: 5164.02
Five Year Review Date: 1/1/2029
Prior Effective Dates: 9/1/2011, 7/16/2018