Medicare Coverage of Biofeedback

What It Is

Biofeedback treatment

What's Covered

Medicare doesn't cover biofeedback treatment.

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 coverage or requires co-payments for biofeedback, contact the plan directly.

What Medicare Pays

Medicare pays nothing for biofeedback treatment.

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

  • The care 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 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 must be performed or delivered by a healthcare provider who participates in Medicare.

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3 Comments So Far. Add Your Wisdom.

about 1 year ago

Medicare also covers pelvic floor biofeedback for urinary incontinence: stress incontinence (leaking with sneezing, laughing, coughing, running or jumping) and urge incontinence, "overactive bladder - wet" (leaking during feelings of urinary urgency)

over 1 year ago is WRONG. Medicare DOES cover biofeedback. Here is Medicare's own website info. This is a link to the web page: National Coverage Determination (NCD) for Biofeedback Therapy (30.1) Tracking Information Publication Number 100-3 Manual Section Number 30.1 Manual Section Title Biofeedback Therapy Version Number: 1 Effective Date of this Version: This is a longstanding national coverage determination. The effective date of this version has not been posted. Description Information Benefit Category: - Incident to a physician's professional Service - Outpatient Physical Therapy Services - Physicians' Services Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service. Item/Service Description Biofeedback therapy provides visual, auditory or other evidence of the status of certain body functions so that a person can exert voluntary control over the functions, and thereby alleviate an abnormal bodily condition. Biofeedback therapy often uses electrical devices to transform bodily signals indicative of such functions as heart rate, blood pressure, skin temperature, salivation, peripheral vasomotor activity, and gross muscle tone into a tone or light, the loudness or brightness of which shows the extent of activity in the function being measured. Biofeedback therapy differs from electromyography, which is a diagnostic procedure used to record and study the electrical properties of skeletal muscle. An electromyography device may be used to provide feedback with certain types of biofeedback. Indications and Limitations of Coverage Biofeedback therapy is covered under Medicare only when it is reasonable and necessary for the individual patient for muscle re-education of specific muscle groups or for treating pathological muscle abnormalities of spasticity, incapacitating muscle spasm, or weakness, and more conventional treatments (heat, cold, massage, exercise, support) have not been successful. This therapy is not covered for treatment of ordinary muscle tension states or for psychosomatic conditions. (See the Medicare Benefit Policy Manual, Chapter 15, for general coverage requirements about physical therapy requirements.)

almost 3 years ago

This is false. Medicare does cover biofeedback, depending on the circumstances.


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