CMS Finalizes Lymphedema Coverage Guidelines and Payments
Due to passage of the Consolidated Appropriations Act, 2023, the Centers for Medicare and Medicaid Services (CMS) will begin to reimburse for lymphedema standard and custom fitted gradient compression garments and other items as determined by the Secretary of Health and Human Services (HHS) beginning January 1, 2024.
On November 1, 2023, CMS released the calendar year (CY) 2024 Home Health Prospective Payment System final rule. In this final rule, CMS finalized the following regarding lymphedema compression treatment items:
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
The content here is for members only log in here or sign up.
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
Check Our Past Webinars!
Leave a Reply
Your email address will not be published. Required fields are marked *This site uses Akismet to reduce spam. Learn how your comment data is processed.
Will you be addressing billing requirements for lymphedema supplies in your 2024 Medicare webinar?
I will be discussing the lymphedema 2024 rules and regulations.
With Medicare now covering garments, bandages, and supplies, is there a reduction in the practice expense (and thus overall reimbursement rate) for CPT 29581 and 29584?
In March 2021, a response on billing bandages to insurance stated that the bandages are part of the practice expense.
You would need to review the RVU’s for CPT codes 29581 and 29584 to see if they changed at all for 2024 compared to 2023. These CPT codes are completely separate and distinct from the HCPCS Level II codes for the lymphedema garments and accessories.
Hello Rick,
This table indicates that the physical therapist would not have to obtain a surely bond. Is it dependent upon the practice?
https://www.palmettogba.com/palmetto/providers.nsf/files/Surety%20Bond%20Exemption%20Chart%2001212021.pdf/$FILE/Surety%20Bond%20Exemption%20Chart%2001212021.pdf
Thanks,
Amy
Do you mean practice or type of outpatient setting such a sprivate practice versus hospital?
Would a physical therapist in an outpatient setting need to obtain a surety bond? Thank you!
For lymphedema garments, yes. For custom made orthotics, no.
Would you be able to provide the link that provides the information you are referencing that a physical therapist is required to obtain a surety bond for lymphedema garments? We are reviewing conflicting information. We are inquiring for a private physical therapy clinic that is solely owned and operated by a physical therapist and they are wanting to follow the “closed model” of providing lymphedema supplies and garments to only patients that establish a POC with them. Thank you!
The criteria for an exemption to a surety bond also includes the business is only billing for orthotics, prosthetics, and supplies. Lymphedema garments are not considered orthotics.