Tracheostomy Care Supplies

Medicare covers tracheostomy care supplies when they are in a Medicare benefit category and are reasonable and necessary per SSA §1862(a)(1)(A), with specific HCPCS-coded usual monthly/periodic maximum quantities. A4625 (starter kit) is covered immediately after open surgical tracheostomy but is not reasonable and necessary after 14 days post-op; convenience item A7523 is not covered, and use of A7527 precludes coverage for A7520/A7521/A7522. Suppliers must have required SWO/WOPD documentation and POD, follow refill contact and delivery timing, and adhere to specified per-code quantity limits and site-specific dispensing limits (1-month nursing facility, 3-month home).

"Tracheostomy care/cleaning starter kit (HCPCS A4625) is covered following an open surgical tracheostomy for the immediate post-operative period."

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