42 C.F.R. § 410.36

Current through October 31, 2024
Section 410.36 - Medical supplies, appliances, and devices: Scope
(a) Medicare Part B pays for the following medical supplies, appliances and devices:
(1) Surgical dressings, and splints, casts, and other devices used for reduction of fractures and dislocations.
(2) Prosthetic devices, other than dental, that replace all or part of an internal body organ, including colostomy bags and supplies directly related to colostomy care, including-
(i) Replacement of prosthetic devices; and
(ii) One pair of conventional eyeglasses or conventional contact lenses furnished after each cataract surgery during which an intraocular lens is inserted.
(3)
(i) Leg, arm, back, and neck braces.
(A) A leg brace may include a shoe if it is an integral part of the brace (necessary for the leg brace to function properly) and its expense is included as part of the cost of the brace.
(ii) Artificial legs, arms, and eyes; and
(iii) Replacements for the devices specified in paragraphs (a)(3)(i) and (ii) if required because of a change in the individual's physical condition.
(4) Lymphedema compression treatment items, including the following:
(i) Standard and custom fitted gradient compression garments.
(ii) Gradient compression wraps with adjustable straps.
(iii) Compression bandaging systems.
(iv) Other items determined to be lymphedema compression treatment items under the process established under § 414.1670 .
(v) For the purposes of paragraphs (i) and (ii) of this paragraph, the scope of the benefit for lymphedema compression treatment items includes accessories such as zippers in garments, liners worn under garments or wraps with adjustable straps, and padding or fillers that are necessary for the effective use of a gradient compression garment or wrap with adjustable straps.
(b) The conditions of payment described in § 410.38(d) also apply to medical supplies, appliances, and devices.

42 C.F.R. §410.36

51 FR 41339, Nov. 14, 1986, as amended at 57 FR 36014, Aug. 12, 1992; 57 FR 57688, Dec. 7, 1992; 84 FR 60801 , Nov. 8, 2019; 88 FR 77874 , Nov. 13, 2023
84 FR 60801 , 1/1/2020; 88 FR 77874 , 1/1/2024