Compression Care Has Created a Medicare Quick Reference Guide for Medical Professionals to Help You Advise Patients

With the launch of the Lymphedema Treatment Act (LTA) on January 1, 2024, Medicare began to cover compression garments for the treatment of lymphedema. As the coverage began, the team at Compression Care worked diligently to understand how the policy functions in action and create the best possible path for implementation. 

We have taken a conservative approach to rolling out our policy to ensure the best financial outcome for our patients. As we move forward into the year, we have further updates about Medicare’s coverage and are announcing our exclusive new Medicare Quick Reference Guide.

Here are the most critical updates to Compression Care’s Medicare Claims Policy:

Medicare Standard vs. Upgraded Garments

We have identified the types of compression garments that can be dispensed within the Medicare standard. Compression Care is providing you with an exclusive Medicare Quick Reference Guide, which breaks down these garment types by manufacturer and specific garment. As you make recommendations for your Medicare patients, this guide will help you refer patients to garments that qualify and identify garments that will be considered upgrades from the Medicare standard because of added features. 

Medicare Standard Garments ~ No Upgraded Features or Modifications

For Medicare standard garments ONLY, Compression Care WILL accept assignments beginning April 1st, 2024, and bill on the patient’s behalf with a signed financial responsibility agreement. These standard garments will be marked with an asterisk (*) in the garment breakdown of the Reference Guide.

Upgraded or Modified Garments Beyond Medicare Standard

For now, we will continue to bill all other non-standard Medicare garments as non-assignment. With upgraded or modified garments, the patient pays up front, AND we will provide a fully detailed and reliable estimate of what the patient should be reimbursed directly by Medicare. To date, patients have been reimbursed for most non-assignment claims within an average of 10 days from the date we file the claim.

Urgent Updates Regarding Medicare Advantage Plans (MAPs)

Details regarding traditional Medicare reimbursement are becoming more and more clear. However, adoption by many Medicare Advantage Plans (MAPs) still remains fluid. We are working with all major carriers who have MAPs to determine when and how they are going to adopt these new codes, and the specifics of their reimbursement schedules. We are now accepting MAPS from the following carriers:

• Aetna
• Humana
• CIGNA

For all other MAPs, please request a benefits check because it may or may not be covered yet.

Our New Medicare Quick Reference Guide Can Help Save You Time

Save yourself time and hassle by downloading our new Medicare Quick Reference Guide. We’ve done all the research on Medicare coverage with the LTA on your behalf and compiled it in one location for your convenience. This document lays out the coverage for standard and non-standard compression garments for lymphedema, a breakdown of billing by Medicare plan type, diagnosis codes, and documentation requirements.

How to Get the Fastest Turnaround for Processing Garment Orders

For patients with traditional Medicare, no benefits check is necessary. For the fastest turnaround service, please send us all of the following information at once:

• Patient Demographics (Including Insurance Card)
• Signed Physician Order (Rx) or Physician-Signed Plan of Care
• Detailed Garment Order
  • Brand
  • Class
  • Style
  • Size
  • Color
  • Qty (3 Day/Body Part, 2 Night/Body Part)
  • Shipping Instructions (Therapist Clinic/Patient Home)

The more information you can provide us, the better. You can’t give us too much information. The above inclusions are minimum requirements, include anything else you have. If in doubt, send it out!

Once we have received all the required information and the patient is at 100% with insurance, we will place the order immediately. If the patient owes anything, we won’t order without checking for patient approval.

Stay Tuned for More Updates!

As the year progresses and we understand more about how Medicare’s coverage of compression garments functions under the Lymphedema Treatment Act, we will continue to update this page with the most important news and information. Helping you and your patients utilize these new Medicare benefits is an integral part of our ongoing commitment to making high-quality compression care more accessible, affordable, and convenient – no matter where you live!

Please don’t hesitate to reach out if you have any questions about LTA implementation or anything else. Thank you for trusting us to care for your patients!

 Contact Information

Joshua Perkins

Chief Operating Officer, Compression Care

Email: [email protected] | Phone: (629) 230-7774

Book a meeting: Q&A with Joshua