Cold Therapy - Policy Article

Cold therapy devices are covered under Medicare's DME benefit only when they meet DME eligibility, LCD-defined reasonable and necessary criteria, and applicable statutory payment requirements. For items subject to Final Rule 1713, a documented face-to-face encounter and a Written Order Prior to Delivery (WOPD) are required before delivery; claims or deliveries that lack these will be denied. Specific HCPCS codes (E0218, A9273, A9270) are referenced for coding guidance and may have differing coverage implications based on whether items qualify as DME and meet LCD R&N criteria.

"Cold therapy devices are covered under the Durable Medical Equipment (DME) benefit when they meet Medicare DME benefit category requirements and are reasonable and necessary (R&N) for the beneficia..."

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