Medicare Coverage of Bone Growth Stimulator

What It Is

An electrical or ultrasound device, to be used by the patient at home, to stimulate bone growth (osteogenesis) during the healing of a bone fracture or fusion

What's Covered

Medicare Part B pays for the rental of a bone growth stimulator if prescribed by a doctor. In addition, before the patient rents or purchases the equipment, the prescribing doctor must send Medicare a written request for approval, called a Certificate of Medical Necessity. The equipment must be rented or purchased from a Medicare-certified medical equipment supplier.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different copayments for a bone growth stimulator, contact the plan directly.

What Medicare Pays

Medicare Part B pays 80 percent of the Medicare-approved amount for rental of a bone growth stimulator; the patient is responsible for the remaining 20 percent.

Warning: If a device is rented from what's called a Medicare "participating supplier," the supplier can't charge more than the Medicare-approved amount. However, a supplier who's enrolled in Medicare but isn't an officially participating supplier may charge more than the Medicare-approved amount. In that case, the patient must personally pay the difference between the Medicare-approved amount and the amount the supplier actually charges (on top of the 20 percent of the Medicare-approved amount that Medicare doesn't pay).

Important: Regardless of the rules regarding any particular type of care or equipment, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care or equipment must meet two basic requirements:

  • The care or equipment must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care or equipment is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care or equipment must be provided by a healthcare provider or equipment supplier who participates in Medicare.

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3 Comments So Far. Add Your Wisdom.

Anonymous said 7 months ago

Medicare Part B will cover up to 80% and the Doctor has to submit a Certificate Of Medical Necessity stating it is medically necessary. The provider must be in the Medicare Program as a Participating Provider. Other providers not in the Program will try to soak you and make you pay. It is important that the physician indicate it is a medical necessity. There is a lot of gray area on if there was a fracture and it did not heal and they want you to wait 90 days etc. Well if it is not associated with a fracture but it is designated as a Medical Necessity, then Medicare should cover. Also, ask for the Procedure Code for the device in question.

Anonymous said about 1 year ago

Because of the cost, most manufactures do not want them reused. So they all have built in timers that permanenty shut them off after three months. So, do not try to buy a used one on e-bay. They are paperweights by then. I am unaware of anybody who rents them. Also, make sure it is covered, because if ti is not, you will be liable.

Anonymous said over 1 year ago

The manufactuer of bone stimulator company says this device cannot be rented and it has to be purchased by Medicare for over $3000.00 dollars Are they lying? Can it be rented? Dr says I only will need it for about three months.


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