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Important Update: Medicare Coverage for Compression Garments under Lymphedema Treatment Act

Published in Government Relations on June 28, 2023

The Lymphedema Treatment Act was passed as part of the omnibus package at the end of 2022 and will go into effect January 2024. The legislation allows Medicare to provide coverage for compression garments when prescribed for medical necessity.

The proposed guidelines are expected to be announced very soon.
Once the proposed guidelines are released, it will be important to review the proposal and submit any questions to CMS during the public comment period.  

What is known prior to the proposed guidelines being released:

  • Both standard and custom compression garments will be included
  • Coverage will be for primary and secondary lymphedema
  • Patients will need to have a prescription for coverage 

What is expected to be part of the proposed guidelines when they are released:

  • Resupply frequency
  • Reimbursement
  • Quantity limits
  • Criteria for specific product options, ie: custom-fit versus standard-fit garments

Additional resources:

Lymphedema Treatment Act Organization

LTA Public Comment period Video Tutorial

VGM is monitoring this closely and will provide more information as it is released.

TAGS

  1. lymphedema
  2. vgm
  3. vgm government

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