Medicare currently has very specific requirements and criteria for coverage of compression products. Our billing experts will help you understand your Medicare benefits and provide an out-of-pocket estimate of the cost to you as part of the verification process.
Please contact us at 1-888-214-4100 with any questions about your Medicare insurance benefits, or email us directly.
FAQ's about Medicare Coverage
Ready-to-Wear Knee High Compression Stockings 30-40mmHg
Ready-to-Wear Knee High Compression Stockings 40-50mmHg
Non-Elastic Gradient Compression Wrap, 30-50mmHg
Compression stockings are only covered when the garments are used in the diagnosis of venous insufficiency and open venous stasis ulcer.
A wound caused by, or TREATED by, a surgical procedure; or,
After debridement of the wound, regardless of the debridement technique
The surgical procedure or debridement must be performed by a TREATING PRACTITIONER or other HEALTHCARE PROFESSIONAL.
Debridement can be any type of debridement (examples given are not all-inclusive)
- Surgical (e.g., sharp instrument or laser)
- Mechanical (e.g., irrigation or wet-to-dry dressing
- Chemical (e.g., topical application of enzymes) or
- Autolytic (e.g., application of the occlusive dressing to an open wound)
- Venous Insufficiency WITHOUT a stasis ulcer
- Prevention of stasis ulcer
- Prevention of the re-occurrence of stasis ulcers that have healed
- Treatment of lymphedema in the absence of ulcer
In these situations, since there is no qualifying wound, the stockings/wraps do not meet the definition of a surgical dressing. Claims for these uses will be denied as NON-COVERED, with no benefit.
The recommended compression garments that are covered by Medicare are:
- Sigvaris Compreflex Lite
- Medi Circaid Juxtalite HD
- Patient Demographic Sheet
- Completed Absolute Medical Order Form
- Initial wound evaluation
- The most recent wound care note lists the following:
- The type of wound (venous stasis ulcer)
- Wound(s) location
- Wound size (length, width) and depth
- Amount of drainage, and
- Any other relevant wound status information
- Once you submitted the above documents to AMI for review, we will send out a request for a written request from the patient’s ordering physician.