How Medicare’s Implementation of the LTA Will Affect Your Patients in 2024
As you are probably aware, Medicare will commence coverage of compression specifically for lymphedema in 2024 when the Lymphedema Treatment Act goes into effect. A lot of information is racing through the industry right now, so we wanted to take a moment to update you on how we are approaching this change here at Compression Care.
Medicare Says Coverage Will Commence January 1st
Medicare has said that patients will be covered as of January 1st, 2024. However, they do have the option to delay coverage to April 1st, 2024. This is still subject to change and is still a likely scenario.
We know you’re anxious to utilize this new coverage for your Medicare patients, and we are working diligently to understand how to advise you and your patients accurately.
Some Key Pieces of the Puzzle Have Yet to be Revealed
As of this writing, Medicare has not released the final list of codes and reimbursements, nor has the Local Coverage Determination (LCD) been issued. Therefore, we lack critical information about what Medicare will pay for, under what circumstances, and at what price.
Therefore, Compression Care will NOT be filing any Medicare claims, assignment or non-assignment, for compression garments until this policy is set forth. To do so prematurely would put the patient and us at risk of not being properly reimbursed. We feel this is the only way to be consistent with our goal that no patient pays more out of pocket than necessary and that no patient ever gets a surprise bill.
How We’ll Keep You Updated
The list of codes and reimbursements is expected “any day” now. We are eagerly awaiting that information, along with the LCD, so we can be specific with you and your patients about what is covered, under what circumstances, and at what price and out-of-pocket cost, if any.
As soon as we can clearly understand and convey reliable coverage information to you and your patients, we will provide a series of detailed updates.
To be clear, we do not expect to be ready to file claims to Medicare on January 1st, 2024. However, as our timeline becomes more clear, we will keep you updated. This is a top priority for our billing team, and we will work as quickly as possible once Medicare takes these remaining actions necessary. The ball is currently in Medicare’s court, as they say.
Thank you for trusting us with the care of your patients!
Joshua Perkins
Chief Operating Officer, Compression Care
Email: [email protected] | Phone: (629) 230-7774