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We break down how L code pricing is set, why crosswalk and gap-fill can fail innovators, and how appeals drain time and cash. Two case studies—Point Designs’ digits and Ethnocare’s volume system—expose how “divide by five” logic and invoice anchoring distort value, while 3D printing and hybrid workflows offer a path forward.

• crosswalk vs gap-fill pricing methods and trade-offs
• pitfalls of 99 miscellaneous codes and ALJ appeals
• point designs digits priced against a mechanical hand
• Ethnocare’s volume management tied to sock costs
• framing comfort as adherence, safety and savings
• click medical as a data-backed reimbursement win
• Medicare recognizing 3D printing as manufacturing
• desktop tpu print farms and reliability advances
• hybrid workflows using load-bearing capture and automation
• fragmentation in O&P advocacy and need for alignment

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We explore how foaming TPU, belt printers, and clinician-led automation can bring custom foot orthoses in-house, cut costs, and reduce lead times from weeks to hours. Fredrik from CADmed shares what actually works, what doesn’t, and how remote design plus per-pair pricing changes the game.

• why automation increases clinician control rather than removes it
• carving versus printing tradeoffs on speed, finish, and cost
• foaming TPU benefits including smoother surfaces and less waste
• belt printers for continuous TPU production and better surface feel
• FDM advantages over powder bed fusion for insoles
• practical lattices and gradients without overengineering
• decentralizing production to clinics for faster delivery
• remote design, slicing, and printer control with per-pair pricing
• scaling systems for reliability, repeatability, and low friction

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We trade trade-show gloss for real-world tactics, then lay out a three-step plan to bring 3D printing into O&P without risking patient care or cash flow. From Bambu-level starters to automated check sockets, we show how to start lean, learn fast, and scale what works.

• Formnext’s shift from machines to applications
• Materialise Bricks for modular workflows and costing
• Multi-material metal, gradient parts, and smarter tooling
• Affordable LPBF and the desktop print farm surge
• Start with a low-cost printer and print clinic tools
• Outsource complex adjustable sockets to free capacity
• Automate transtibial check sockets for speed and margin
• Scanner choices from budget to pro with trade-offs
• A three-tier roadmap to adopt and scale digital O&P

Special Thanks to Advanced 3D for sponsoring this episode.

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