If you are covered under any other type of health insurance, including a Medicare Advantage plan, the details of your coverage benefits will be determined by your plan and you should contact them for details.
HOME HEALTH: lymphedema compression garments and supplies are billable and covered under Part B benefits while the patient is receiving Home Health.
NURSING FACILITY or SKILLED NURSING FACILITY: lymphedema compression garments and supplies are billable and covered under Part B benefits while the patient is receiving care in either of these types of facilities only when the beneficiary is not in a covered Part A stay. For a beneficiary covered under Part A, the items are included in the bundled Part A payment.
HOSPICE: lymphedema compression garments and supplies are billable and covered under Part B if items are not related to the hospice termination conditions or a related condition. This determination is made by the hospice treating physicians and they should complete a valid Hospice Election Statement Addendum on file. A complete list of the requirements for this document is published here: CMS Benefit Policy Manual, Ch. 9, Section 20.2.1.2. Part B suppliers should bill the claims with the GW modifier once they have the properly completed Hospice Election Statement Addendum.
If you have been denied coverage by your plan for any reason, please use our Denial Reporting Form. It is important that we hear from anyone who is not receiving coverage so that we can work to address remaining coverage gaps. Additionally, follow the steps on our Contact Your Insurance Company page.
