Medicare Coverage
The Lymphedema Treatment Act (LTA) is a bill that was passed by Congress in December of 2022 to enable Medicare coverage for lymphedema compression garments and supplies. The new coverage went into effect on January 1, 2024. The information below is specific to traditional Medicare, however, most other insurance plans eventually follow Medicare precedent.
Medicare will pay for lymphedema compression treatment items for Medicare Part B patients.
What's Covered
Medicare will 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?
Medicare will pay for compression garments:
- Daytime: 3 garments per affected body part every 6 months
- Nighttime: 2 garments per affected body part every 2 years
Medicare will 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?
Medicare will 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
How to Order
As a therapist, please submit patients’ medical records through one of the following platforms :
- Fax 866-860-9358
- Email orders@absolutemedical.com
- Absolute Access Login – click here
Please send Absolute Medical the following documents:
- Patients Demographic Sheets
- Copies of front and back Insurance Cards
Once the patient’s benefits have been verified, Absolute Medical will follow up with the patient and schedule an appointment for the evaluation of compression garments
To complete the order, Absolute Medical will follow up with the patient for:
- Clinical Notes detailing the need for compression garments from either the prescribing physician or the treating Lymphedema Therapists.
- Signed Prescription for the compression garments from the patient’s prescribing physician
Absolute Medicare will order the compression garments once all the necessary documents have been received. Absolute Medical will complete the fitting, ensure everything is fitting correctly, and follow up with the patient or therapist on any concerns they have with the garments.
Absolute Medical will be filing assigned claims for compression garments to Medicare. If you have any questions, please email customerservice@absolutemedical.com or call our Customer Service team at 312-233-2207. Thank you, and we look forward to assisting you with your compression garment needs!