Effective January 1, 2024, Medicare has expanded its coverage to include lymphedema compression treatment items—a major change for DME and HME providers. At TheDMEConsultant, we’re here to help you stay informed and compliant with these updates to better serve your patients.
✅ What’s Covered?
Medicare now reimburses for standard and custom-fitted lymphedema compression treatment items, including:
- Daytime gradient compression garments
- Nighttime gradient compression garments
- Compression wraps with adjustable straps
- Bandaging systems and compression supplies
- Accessories: donning/doffing aids, linings, fillers, padding, and zippers
This coverage applies per affected body part and is a game changer for those managing chronic lymphedema.
🔁 Coverage Frequency
- Daytime Garments: Up to 3 per affected area every 6 months
- Nighttime Garments: Up to 2 per affected area every 2 years
- Replacements: Covered in cases of loss, theft, damage, or significant changes in condition
📝 Eligibility Requirements
To qualify for coverage:
- The patient must have Medicare Part B
- A prescription is required from a licensed healthcare provider
- The items must be customarily used to treat lymphedema
📋 Supplier Enrollment Guidelines
If you want to bill Medicare for these items, you must be enrolled as a DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) supplier.
🛠 Provider Responsibilities
As a DMEPOS supplier, you’re responsible for:
- Measuring and fitting
- Providing training on use and care
- Adjustments and replacements
- Ensuring proper documentation and compliance
Even if you outsource the fitting, you remain accountable for the full service delivery.
💼 Billing and Coding
Use the appropriate HCPCS codes listed in the January 2024 Alpha-Numeric HCPCS File. This ensures accurate claims processing and reimbursement.
These 2024 Medicare updates are a step forward for patient care and a valuable opportunity for DME providers. At TheDMEConsultant, we help you stay ahead with expert insights and compliance support.
Need help implementing these updates or ensuring Medicare compliance? Contact The DME Consultant today!
