Lymphedema Compression Treatment Items
Starting January 1, 2024, Medicare will pay for lymphedema compression treatment items for Medicare Part B patients.
What’s Covered?
We’ll pay for standard and custom-fitted lymphedema compression treatment items for each affected body part, including:
- Compression garments, including those for daytime and nighttime, which offer different levels of compression
- Compression bandaging systems and supplies provided during the initial decongestion phase and maintenance phases of treatment
- Gradient compression wraps with adjustable straps
- Necessary accessories for gradient compression garments and wraps, including:
- Aids for putting on and taking off (donning and doffing) items for different body parts, like lower limb butlers or foot slippers that help patients put on compression stockings
- Fillers
- Lining
- Padding
- Zippers
How Often?
We pay for compression garments:
- Daytime: 3 garments every 6 months
- Nighttime: 2 garments every 2 years
We also pay for items, as needed:
- To replace lost, stolen, or irreparably damaged items
- If a patient’s condition changes, like a change in limb size
Who’s Eligible?
We’ll pay for these treatment items when:
- The patient has Medicare Part B coverage (their annual Part B deductible and 20% coinsurance will apply)
- The patient has lymphedema (a chronic condition that causes swelling in the body's tissues) and will use the item to primarily and customarily treat it
- An authorized practitioner prescribes the item
Can I Furnish These Items?
You must be an enrolled DMEPOS supplier to get Medicare payment for furnishing these treatment items. Become a DMEPOS supplier.
What Are My Responsibilities?
When you furnish a lymphedema compression treatment item, you’re responsible for all aspects of providing the item, unless you work out an arrangement with a professional fitter to perform the services. This includes:
- Taking measurements of the patient’s affected body area
- Performing necessary fitting services
- Training the patient how to take the treatment item on and off
- Showing the patient how to take care of the treatment item
- Adjusting the treatment item, if needed
How Can I Bill?
Starting January 1, use new and existing codes in the January 2024 Alpha Numeric HCPCS File. We’ll publish the January file soon.
Where Can I Get More Information?
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