Centers for Medicare & Medicaid Services

Content Section

Publication Number

100-3

Manual Section Number

30.1.1

Version Number

Effective Date of this Version

7/1/2001

Implementation Date

7/1/2001

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.

Indications and Limitations of Coverage

This policy applies to biofeedback therapy rendered by a practitioner in an office or other facility setting.

Biofeedback is covered for the treatment of stress and/or urge incontinence in cognitively intact patients who have failed a documented trial of pelvic muscle exercise (PME) training. Biofeedback is not a treatment, per se, but a tool to help patients learn how to perform PME. Biofeedback-assisted PME incorporates the use of an electronic or mechanical device to relay visual and/or auditory evidence of pelvic floor muscle tone, in order to improve awareness of pelvic floor musculature and to assist patients in the performance of PME.

A failed trial of PME training is defined as no clinically significant improvement in urinary incontinence after completing 4 weeks of an ordered plan of pelvic muscle exercises to increase periurethral muscle strength.

Contractors may decide whether or not to cover biofeedback as an initial treatment modality.

Home use of biofeedback therapy is not covered.

Transmittal Number

138

Transmittal Link

http://www.cms.hhs.gov/transmittals/downloads/R138CIM.pdf

Revision History

05/15/2001 - Deliniated coverage policy. Effective and implementation dates 07/01/2001. (TN 138) (CR 1535)

Claims Processing Instructions

TN AB-01-79 (Program Memorandum Intermediaries/Carriers)

National Coverage Analyses (NCAs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with NCAs, from the National Coverage Analyses database.

Add to basket | Email this to a friend | New Search