Medicare & The Lymphedema Treatment Act: A Complete Guide to Coverage, Eligibility, and Reorders

Until 2024, thousands of Americans living with lymphedema discovered that the single most-effective daily treatment—medical-grade gradient compression garments—were not covered by Part B. Out-of-pocket costs soared, outcomes suffered, and many people simply went without the stockings, sleeves, wraps or bandages their physicians prescribed.

That changed when Congress passed the Lymphedema Treatment Act (LTA) in December 2022. On January 1^st, 2024, the law created an entirely new Medicare benefit category and unlocked nationwide reimbursement for compression items. This guide explains:

• What the LTA does and why it was needed
• Which garments and supplies are now covered under Medicare lymphedema coverage
• How many garments you can receive—and how often you can reorder (with an infographic)
• Step-by-step instructions for getting approved
• What the LTA means for Medicare Advantage, Medicaid and commercial lymphedema insurance plans
• Where to buy Medicare-approved products online

This comprehensive guide will provide everything you need to know about the Lymphedema Treatment Act, Medicare lymphedema coverage, and how to make the most of your benefits. Whether you’re a patient, caregiver, or clinician, this article will help you understand coverage, eligibility, timelines, and where to find Medicare-approved compression garments.

Lymphedema is a chronic, progressive swelling that occurs when lymphatic vessels or nodes are damaged or absent. Untreated, it leads to fibrosis, infections, limited mobility and diminished quality of life. Daily application of correctly fitted, graduated compression supplies is the cornerstone of management, supported by exercise, meticulous skin care, manual lymphatic drainage (MLD) and, when needed, pneumatic pumps.

Compression therapy is the cornerstone of lymphedema management. It helps reduce swelling, prevents fluid buildup, and supports the lymphatic and venous systems. Medical-grade compression garments—like sleeves, stockings, and wraps—are essential for controlling the condition and avoiding complications.

For years, advocates argued that compression supplies met Medicare’s “medical and therapeutic” standard but had no home under existing benefit categories. The bipartisan LTA—championed by patient advocates and the Lymphedema Advocacy Group—was finally signed into law within the 2023 Consolidated Appropriations Act. It directed CMS to recognize compression treatment items as Durable Medical Equipment (DMEPOS) starting in 2024. (Home | The Lymphedema Advocacy Group)

CMS issued policy transmittals and new HCPCS codes establishing coverage rules for both standard-sized and custom-made gradient compression items. (Centers for Medicare & Medicaid Services) Highlights include:

Once your annual Part B deductible is met ($240 in 2024), you pay 20 % of the Medicare-approved amount; Medicare pays the remaining 80 %. (Medicare) If you have Medigap or a supplemental plan, that 20 % may be partially or fully covered.

CMS groups items into three broad categories:

1. Daytime gradient compression garments or wraps – circular- or flat-knit stockings, sleeves, gauntlets, gloves, knee-highs, thigh-highs, arm sleeves, wraps with adjustable straps.
2. Nighttime garments – quilted, foam-chipped, or low-stretch (classically “reduction” or “night-wear”) garments.
3. Compression bandaging supplies & accessories – short-stretch bandages, padding, liners, directional flow pads, donning/doffing aids, and other components required for Complete Decongestive Therapy (CDT).

Standard-sized garments are billed under new HCPCS codes Axxxx series, while custom-fitted items have their own codes ending in -CF. Custom orders require detailed measurements and a prescription specifying “custom” on the order. (Centers for Medicare & Medicaid Services)

Medicare allows the following quantity/frequency limitations per affected body area: (CGS Medicare, Noridian Medicare)

Important: If a garment is lost, stolen, or damaged beyond repair, a supplier may provide an early replacement with proper documentation.

Below is an easy-to-follow visual schedule that illustrates three common reorder scenarios for daytime garments.

The graphic shows that regardless of whether you receive one, two, or all three garments in January, you are not eligible again until July—six calendar months after the first Date of Service.

• Medicare Advantage (MA): MA plans are required to cover everything Traditional Medicare does, but may use different supplier networks and prior-authorization rules. Contact your plan for specifics.
• Medicaid: While the federal statute does not bind state Medicaid programs, historically Medicaid follows CMS precedent. Early 2024 data show multiple states issuing bulletins adopting the new benefit.
• Commercial Plans / Employer Coverage: Private insurers frequently mirror Medicare coding and quantity limits (“CMS cross-walk”). If you have employer coverage only, reference the LTA when appealing denials.

• 20 % Coinsurance: After deductible, you owe 20 % unless you have Medigap Plan C, F, or G (all of which generally absorb the coinsurance).
• Secondary Insurance: Many Medicare beneficiaries also hold Medicaid (dual-eligible) or a retiree plan that covers the 20 %.
• Flexible Spending / HSA: Garments are HSA-eligible medical expenses.
• Manufacturer Assistance: Certain brands provide patient-assistance discounts for custom garments; ask your supplier.

LymphedemaProducts.com is an enrolled Medicare DME supplier specializing in compression therapy. The site:

• Lists all daytime, nighttime, and bandaging items with their new HCPCS codes
• Offers an online order form that meets Medicare documentation rules
• Provides free fitting support via certified lymphedema therapists and professionals
• Ships directly to your door and files the claim on your behalf

Because inventory is curated for Medicare lymphedema coverage, you avoid trial-and-error shopping and denied claims.

• The Lymphedema Treatment Act finally provides nationwide Medicare lymphedema coverage for compression therapy.
• Beneficiaries are eligible for three daytime garments every six months and two nighttime garments every two years, plus bandaging supplies.
• Obtain a detailed prescription, choose a Medicare-enrolled supplier, and understand the reorder clock (see infographic).
• LymphedemaProducts.com streamlines the entire process with Medicare-ready product lines and direct billing services.

1. Centers for Medicare & Medicaid Services. Implementation of New Benefit Category for Lymphedema Compression Treatment Items (CR 13286). January 2024. (Centers for Medicare & Medicaid Services)
2. CMS DMEPOS Fee Schedule: Lymphedema Compression Treatment Items page. (Centers for Medicare & Medicaid Services)
3. CGS Medicare. Lymphedema Compression Treatment Items Fact Sheet. December 2023. (CGS Medicare)
4. Noridian Healthcare Solutions. Lymphedema Compression Treatment – Quantities & Billing. 2024. (Noridian Medicare)
5. Medicare.gov. Coverage for Lymphedema Compression Treatment Items. Accessed May 2025. (Medicare)
6. Lymphedema Advocacy Group. FAQ – Lymphedema Treatment Act. February 2024. (Home | The Lymphedema Advocacy Group)