The recent passage of the Lymphedema Treatment Act is monumental in helping patients get financial relief from the costs of treatment and maintenance of lymphedema. This Medicare benefit now provides more advantageous choices for the patient AND the clinician.
How to select the best compression therapy garment for patients?
Lymphedema is individualized to the specific patient, therefore there really is not one product but a collection of products that can help treat patients.
When making a garment selection, a clinician must consider the following therapeutic needs of the individual patient:
- Level of containment – the more robust or stiff the material, the more containment
- Patient activity – some materials and features allow for more freedom of motion during activity
- Application needs – making good style selections can influence patient compliance
As your patient’s clinician, it’s important that you select the best product that not only meets your standards for the best personal outcome for your patients, but that also allows you to be successful in your clinic.
Know your Medicare provider.
There is much more to servicing lymphedema patients than the ability to bill Medicare. Certified lymphedema therapists provide expert services, including Manual Lymphatic Drainage techniques, exercise, compression garment fitting, and education to help patients best manage their condition.
What is the LTA coverage for compression therapy products?
The Lymphedema Treatment Act, passed by Congress at the end of 2022, mandated the creation of a new Medicare benefit category to cover reimbursement of compression garments and supplies used for the treatment of lymphedema. Prior to the development of this new benefit category, many compression garments and other treatment items were not guaranteed reimbursement, forcing patients to purchase garments and other treatment items based on what they could afford, instead of receiving the items that would be most beneficial to address their treatment needs.
Under the new bill, Medicare will cover standard and custom-fitted lymphedema compression garments for each affected body part:
- Daytime use compression garments – 3 per affected body part every 6 months. This includes ready-to-wear and custom garments, both flat-knit and circular-knit stockings, and inelastic wraps.
- Night care garments: 2 nighttime garments every 24 months.