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.
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
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
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).