Article
Regulatory Update: Medicare Clarifies Lymphedema Compression Garments Replacement Policy
Updated on April 25, 2025
COMPASS POINT: In April 2025, Durable Medical Equipment MACs updated guidance on replacing compression garments for those treated for lymphedema.
On April 1, 2025, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) updated their guidance regarding compression garment replacement for lymphedema treatment. Under Medicare, beneficiaries can receive up to three compression garments per affected body area every six months.1
This updated policy includes exceptions for this six-month timeline, which allows for earlier garment replacement under specific circumstances. A new set of three replacement garments may be provided if one or more are lost, stolen, or irreparably damaged, or if a patient’s medical condition changes, thereby necessitating a new garment size. In such cases, the six-month replacement cycle restarts from the date of the new issuance.1
For claims involving lost, stolen, or damaged original garments, providers must use the RA modifier to indicate the reason for the replacement.1
See related content below for a deeper analysis of this development from Dr. Jeffrey Lehrman.
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