Lymphedema Compression Treatment Items

This content is for health care providers. If you’re a person with Medicare, learn more about your Medicare coverage for lymphedema compression treatment items .

Starting January 1, 2024, Medicare will pay for lymphedema compression treatment items for Medicare Part B patients.

What’s Covered?

We’ll 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?

  We pay for compression garments:

  • Daytime: 3 garments per affected body part every 6 months
  • Nighttime: 2 garments per affected body part every 2 years

  We 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?

  We’ll 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

  Can I Furnish These Items?

  You must be an enrolled DMEPOS supplier to get Medicare payment for furnishing these treatment items. Become a DMEPOS supplier .

  If you’re enrolling in Medicare for the first time to supply lymphedema compression treatment items, submit a letter stating this with your application. We’re working on updating the CMS 855S to include these items.

  What Are My Responsibilities?

  When you furnish a lymphedema compression treatment item, you’re responsible for all aspects of providing the item, unless you work out an arrangement with an external fitter to perform the services. This includes:

  • Taking measurements of the patient’s affected body area
  • Performing necessary fitting services
  • Training the patient how to take the treatment item on and off
  • Showing the patient how to take care of the treatment item
  • Adjusting the treatment item, if needed

  How Can I Bill?

  Starting January 1, use new and existing codes in the January 2024 Alpha Numeric HCPCS File.

  Where Can I Get More Information?

  • Final Rule
  • Section 4133 of the Consolidated Appropriations Act (CAA)
  • Section 1834(j) of the Act
  • Medicare Benefit Policy Manual, Chapter 15 (PDF) :
    • Section 110.8: DMEPOS benefit category determinations
    • Section 145: covered items, replacements, and frequency limitations
    • Section 181.1: payment policy