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

From Our Experts

Important: HME Supplier Survey on Round 2028 Competitive Bidding Impact thumbnail Important: HME Supplier Survey on Round 2028 Competitive Bidding Impact AAHomecare is conducting a brief survey to help quantify the potential impact that Medicare's Remote Item Delivery (RID) model of Competitive Bidding would have on HME suppliers providing continuous glucose monitors (CGMs), insulin pumps, ostomy supplies, and/or urological supplies. Survey findings will be used to inform discussions with the White House, the Centers for Medicare and Medicaid Services (CMS), and Congress about the potential effects on supplier businesses, jobs, and patient... CMS Makes Finalized Change to DMEPOS Competitive Bidding Program thumbnail CMS Makes Finalized Change to DMEPOS Competitive Bidding Program The Centers for Medicare and Medicaid Services (CMS) has issued the FY 2027 Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) Final Rule (CMS-1845-F), increasing the DMEPOS Competitive Bidding Program's bid surety bond amount to $100,000 (previously $50,000).... VGM Government Relations Launches State Payer Resource Hub for DMEPOS Providers thumbnail VGM Government Relations Launches State Payer Resource Hub for DMEPOS Providers This resource brings together key information frequently used by DMEPOS providers. Kentucky Governor Announces Reprieve from Previously Announced Kentucky Medicaid 4% Rate Cut thumbnail Kentucky Governor Announces Reprieve from Previously Announced Kentucky Medicaid 4% Rate Cut The administration expects the surplus funding to sustain current reimbursement levels through June 2027. NAAOP and OPGA Co-Host Second Annual In-Person Legislative Fly-In thumbnail NAAOP and OPGA Co-Host Second Annual In-Person Legislative Fly-In Last week, over 30 stakeholders, advocates, and leaders from around the O&P profession convened at the offices of Powers Pyles Sutter & Verville PC in Washington, D.C., as part of the National Association for the Advancement of Orthotics and Prosthetics' (NAAOP) second annual in-person legislative fly-in. Round 2028 Updates for Competitive Bidding & Interoperability Rule FAQ thumbnail Round 2028 Updates for Competitive Bidding & Interoperability Rule FAQ On Nov. 28, 2025, the Centers for Medicare & Medicaid Services (CMS) announced plans for Round 2028 of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). If you plan to bid, the time to prepare is now... What DMEPOS Providers Need to Know About H.R. 3514: Improving Seniors' Timely Access to Care Act thumbnail What DMEPOS Providers Need to Know About H.R. 3514: Improving Seniors' Timely Access to Care Act Medicare Advantage prior authorization continues to be one of the most significant operational and patient care challenges facing DMEPOS suppliers. A new bipartisan bill, H.R. 3514: Improving Seniors' Timely Access to Care Act, seeks to increase transparency, accountability, and oversight of Medicare Advantage prior authorization practices. This bill passed out of Ways & Means markup by a unanimous vote (42-0) on July 15... H.R. 1703 Advances, Bringing Greater Choice for Wheelchair Users thumbnail H.R. 1703 Advances, Bringing Greater Choice for Wheelchair Users The DMEPOS community, particularly wheelchair providers and users, should be celebrating an important victory as the House approved the Choices for Increased Mobility Act (H.R. 1703).