Biofeedback for Urinary Incontinence
Biofeedback is defined as a therapy that uses electronic or mechanical instruments to relay visual and/or auditory evidence to assist a person to gain pelvic muscle awareness to improve physiologic activity and bladder function.
Currently, §35-27 of the Coverage Issues Manual states that biofeedback is covered under Medicare only when it is reasonable and necessary for the individual patient for muscle re-education of specific muscle groups or for treating pathological muscle abnormalities of spasticity, incapacitating muscle spasm, or weakness, and more conventional treatments have not been successful. Therefore, coverage of biofeedback for the treatment of urinary incontinence is determined at the carrier level. HCFA will evaluate whether the current literature supports a national position on the use of biofeedback for the treatment of urinary incontinence.
Pelvic Floor Electrical Stimulation for Urinary Incontinence
Pelvic Floor Electrical Stimulation (PFES) for urinary incontinence refers to the use of a non-implantable electrical device that delivers variable rates of current through the pelvic floor with the intent of strengthening pelvic floor musculature.
Currently, §65-9 (C) of the Coverage Issues Manual states that the effectiveness of these devices is unproven, and therefore cannot be covered under §1862(a)(1) of the Social Security Act as a "reasonable and necessary" treatment. HCFA is currently evaluating this issue to determine whether sufficient scientific evidence exists to allow for a reconsideration of this national policy.