Lymphedema Compression Treatment Items

This content is for health care providers. If you’re a person with Medicare, learn more about your Medicare coverage for 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 per affected body part every 6 months
  • Nighttime: 2 garments per affected body part 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.

If you’re enrolling in Medicare for the first time to supply lymphedema compression treatment items, submit a letter stating this with your application. We’re working on updating the CMS 855S to include these items.

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 an external 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.

For more information on billing, view MLN Matters: Lymphedema Compression Treatment Items: Implementation (PDF).

Where Can I Get More Information?

Page Last Modified:
12/14/2023 09:59 AM