What have we learned after year one of the implementation of the Lymphedema Treatment Act?
First, CMS appears to see value in treating lymphedema. Have they seen a reduction in secondary conditions such as cellulitis and other ailments? That is too early to determine. However, CMS has implemented additional HCPC codes, increased reimbursement rates, and has been diplomatic in working through industry deliberations.
Second, CMS recognizes the need for garments during all phases of lymphedema treatment:
Treatment or reduction phase to supplement the decongestion treatment in clinic and at home = circaid® reduction kit™ for legs, arms, trunk, head & neck
Transition phase to stabilize volume after treatment when patient is transitioning from clinical care to self-care or aided care = circaid® juxtafit garments
Maintenance phase to enable patients’ long-term healthy lifestyle = mediven® flat-knit and circular-knit products
Nighttime garments for continued therapy at night = circaid® profile foam garments
Demand for lymphedema treatment and garments has increased significantly while the number of localized fitters/billers has remained stagnant. This creates a sizable opportunity for the O&P community to expand its footprint while capitalizing on a lifetime treatment supply program.
How can medi® help?
- Full line of lymphedema product solutions with PDAC letters
- Education and training with ABC/BOC CEUs - learn more at medi U
- Local support and clinical relationships
- Billing and documentation support
