Does Medicare cover Cold Laser Therapy (CLT)?

Pain reduction treatment options such as cold laser therapy provide much-needed relief. Does Medicare cover cold laser therapy? CMS has determined that low-level laser therapy is not covered for treatment of specific diagnoses or pain due to certain conditions. Read on to learn about under what conditions Medicare covers cold laser therapy.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Apr 6, 2021

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The Highlights

  • Low-level laser therapy, also called cold laser therapy, is non-covered as skilled therapy services
  • Cold laser therapy is a relatively new and non-invasive treatment option for pain with incomplete information for optimal treatment protocols
  • Other insurance options are available if you need cold laser therapy coverage

Whether you want cold laser therapy on Medicare or already receive cold laser therapy and want Medicare coverage, you need to understand the requirements needed to get your insurance to pay for cold laser therapy.

Does Medicare cover cold laser therapy? Any service must meet Medicare’s guidelines for reasonable and necessary treatment. Outpatient therapy coverage guidelines have basic requirements in common.

Medicare lists cold laser therapy to be a non-covered skilled therapy service. Without much work from your healthcare provider and their team, Medicare won’t cover cold therapy treatment.

There are many different health insurance groups and coverages available to buy. If you specifically need cold laser therapy coverage, there are options available for you.

Grab your free Medicare insurance quotes by entering your ZIP code today.

Does Medicare cover cold laser therapy?

Medicare is a defined benefit program. An item or service must fall within a benefit category as a prerequisite to Medicare coverage.

The Centers for Medicare & Medicaid Services (CMS) evaluates relevant clinical evidence to determine whether or not the evidence is of sufficient quality to support a finding that an item or service is reasonable and necessary for the diagnosis or treatment of a patient.

An improved health outcome is one of several considerations in determining whether an item or service is reasonable and necessary.

Infrared therapy devices may fall within the benefit category of durable medical equipment. Infrared therapy also may be provided as services and supplies furnished incident to a physician’s service.

Even hospital services incident to a physicians’ services rendered to outpatients and outpatient physical therapy services may have documentation allowing coverage in unique patient situations.

The treatment plan should strive to provide treatment in the most efficient and effective way, balancing the best achievable outcome with the appropriate resources.

Therefore, the CMS concluded that infrared devices are not reasonable and necessary for the treatment of Medicare beneficiaries for diabetic and non-diabetic peripheral sensory neuropathy, wounds and ulcers, and similar related conditions, including symptoms such as pain from these conditions.

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What is cold laser therapy?

Cold laser therapy is a non-invasive procedure for pain relief that does not require a surgical incision or medications. There are no prolonged recovery times and no serious side effects when used properly by a doctor.

It can be used alone or with other treatment options. Medicare covers alternative medicine that also avoids surgical incisions or medications.

When applied to the skin, these lasers produce no sensation and do not burn the skin. Due to the low absorption by the skin, it’s hypothesized that laser light penetrates deeply into the tissues.

The exact mechanisms of its effect on tissue healing are unknown.

Is cold laser therapy the same as low-level laser therapy?

Low-level laser therapy can also be called photobiomodulation, cold lasers, or non-thermal lasers. It refers to the use of red-beam or near-infrared lasers.

What are the benefits of cold laser therapy?

Cold laser therapy can be used independently or in combination with other treatment options. Patients seeking pain relief or pain reduction without surgery or medications will appreciate cold laser therapy.

It is a viable treatment option for certain types of pain by most health care professionals. Adding this method among other tools to help with pain relief can increase results.

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Why should I not consider cold laser therapy?

Cold laser therapy is a new treatment option. There is incomplete information about its optimal treatment protocol.

It requires a series of usually 8-30 treatments for pain relief or the resolution of pain symptoms. Treatments occur 2-4 times per week, and old injuries may be aggravated for several days after treatment.

Medicare and Medicaid do not cover cold laser therapy expenses. However, other major medical insurance companies do have coverage options.

Cold laser therapy shouldn’t be used with any carcinoma, or suspicious cancerous lesions, over the thyroid, or with known or suspected pregnancies. The laser should also be kept away from the eyes.

Do you need cold laser therapy treatment but need additional affordable Medigap insurance rates? Enter your ZIP code to receive your free quotes today.

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