National Coverage Analysis (NCA) Tracking Sheet

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.

Benefit Category

Incident to a physician's professional Service
Outpatient Physical Therapy Services
Physicians' Services

Requestor Information

Requestor Name Requestor Letter
HCFA internally generated request N/A

Important Dates

Formal Request Accepted and Review Initiated
Expected NCA Completion Date
Public Comment Period
03/01/2000 - 04/01/2000
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released


Lead Analysts
Anthony Norris
Lead Medical Officers

Medicare Benefit Category Determination Date

Actions Taken

February 24, 2000

Referred to MCAC Medical and Surgical Procedures Panel, scheduled to meet on April 12 and 13, 2000.

Referred to the Center for Health Plans and Providers (CHPP) for final benefit category determination.

March 27, 2000

Technology assessment and exclusion tables posted.

April 7, 2000

Benefit category determination made by CHPP.

April 12, 2000

The Medical and Surgical Procedures panel  of the MCAC met in Baltimore, Maryland. (See Meeting Information.) The panel concluded that for patients with stress, urge, and post-prostatectomy incontinence, the evidence was not adequate to draw conclusions about the effectiveness of biofeedback as an adjunct to pelvic muscle exercises (PME) in routine clinical use in the Medicare population.

June 6, 2000

The Executive Committee  of the MCAC met in Baltimore, Maryland. (See Meeting Information.) They reviewed and ratified the findings of the Medical and Surgical Procedures Panel.

July 25, 2000

Formal MCAC Executive Committee recommendation received by HCFA. Current due date amended.

October 6, 2000

Decision made. See Decision Memorandum.