Pac Ortho provides educational materials and training geared towards the assessment of individuals and the prevention of future injuries. Pac Ortho is staffed by a team of medical experts who are ready and willing to help reduce any risk of injury.

While you can’t order the Moore Balance Brace online due to measuring and authorization needs, below are materials necessary to understand the process and facilitate each step of the order. Please feel free to download and print any forms and reach out to us via the email contact form on the Contact page on this site for explanations and guidance through the easy steps.


You DO NOT have to use our form, BUT, evals must include:

  • DX Pertinent to bracing
  • Assessment of the foot/ ankle ROM and strength
  • Balance test and scores
  • Gait quality
Biomechanical Assessment
Tinetti Assessment Tool: Balance and Gait


See links below for forms you may need for your patients.

MBB Order Form


Home Care, Assisted Living and Out-Patient:

Patient’s Medicare and/or private insurance covers MBB’s. Medicare covers 80%, and secondary insurance covers the remaining 20%. Private insurance usually has a co-pay that varies according to each plan. Some Medicare Advantage Plans contract with us to allow their patients to obtain MBB’s. New insurance companies are recognizing the benefits of our fall prevention program, and are coming online every month.


Acute Care and Sub-Acute:

MBB’s are covered by the same insurance guidelines as when the patient is in home care or out-patient care. However, they cannot be delivered until the patient goes home. Otherwise, the facility would incur the cost of the devices.


Long Term Care:

Once the patient has to have been on Long-term care for at least 100 days, for their insurance to pay for devices they are eligible for insurance to cover MBB’s. Medicare pays 80% and their Medicaid or secondary insurance will pay the remaining 20%. Some patients’ LTC is covered by a managed care insurance or a capitation, which requires prior authorization.


Fall Prevention Process


Your patient might be appropriate for MBB’s:
  • Write order in the chart: “MBB assessment and casting if appropriate.”
  • Complete the Biomechanical Evaluation


Your patient is appropriate for MBB’s:
  • Complete Rx and CMN forms (must be signed by patient’s physician)
  • Obtain a current H&P (within 6 months)
  • Obtain Demographics with patient address, days since admission, and insurance information
  • EMAIL or FAX documentation to: Clinicare Orthotics, Attn: Ashley/Billing Dept, or Fax (909) 777-5005. Ashley will send you a response with an Authorization Code and information regarding patient co-pays if any.


BEST PRACTICE: Discuss any costs with patient, so they can decide if they want to proceed.


Casting your patient:
  • Complete MBB Order Form, including the Authorization Code
  • Pack impressions in a box for shipping (you can mail multiples in each box)
  • Call Amanda/Shipping Dept at (909) 777-5000, option 3 to send UPS to pick up the box. They will usually come the next day.


When MBB’s arrive:
  • Write order in chart: “MBB fitting and increase therapy frequency, if appropriate.”


BEST PRACTICE: Test patient’s balance without braces, then retest with MBB’s donned.


  • Document both scores in the chart.
Donning the Moore Balance Brace
Casting the Moore Balance Brace