CMS Finalizes Lymphedema Coverage Guidelines and Payments

For what diagnosis codes will CMS reimburse for standard and custom fitted gradient compression garments? Who can prescribe standard and custom fitted gradient compression garments? Will therapists need to enroll as a DME supplier in order to bill the Medicare program for the lymphedema garments? What payment rate did CMS finalize for the lymphedema compression gradient garments? If a therapist takes the measurements and does the fitting, but the gradient compression garment is provided by someone else, how does the therapist get paid for their time? Will accessories that are not compression garments be covered under this new benefit? Which codes did CMS finalize to cover for gradient compression stockings? Which Medicare Administrative Contractor (MAC) would reimburse for the lymphedema compression garments and accessories? What percentage will CMS reimburse for the lymphedema compression garments and supplies? What are the frequency limitations for lymphedema compression treatment items? What are some examples of lost, stolen, or irreparably damaged lymphedema compression garments? How will CMS adjust payment rates from one year to the next year? Where can I read more about this final rule?

---