Biofeedback Therapy for the Treatment of Urinary Incontinence

CMS National Coverage Determination | ncd_id=42 | manual_section=30.1.1 | coverage_level_code=2 | national_coverage_type=True | under_review=True | lab_ncd=False

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.

Revision History: 05/15/2001 - Deliniated coverage policy. Effective and implementation dates 07/01/2001. ( TN 138 ) (CR 1535) Benefit Categories: 33 - Incident to a physician's professional Service; 48 - Outpatient Physical Therapy Services; 52 - Physicians' Services Transmittal: transmittal_number=138 | transmittal_issue_date=2001-05-15 | change_request_number=1535