04/04/2023

Shockwave Coverage-Medicare

Is shockwave therapy a covered benefit through Medicare? Are there any guidelines that would cover shockwave therapy. If it is covered is one type covered vs the other: radial vs. focus? I am looking at CMS.gov LCD and there are no true guidelines.

Shockwave therapy is not a covered benefit for Medicare beneficiaries. Only one Medicare contractor has a policy, and the modality is considered experimental and not covered under any circumstances. Per the LCD policy, “ ESWT (high energy) is not reasonable and necessary for the treatment of musculoskeletal conditions and therefore not covered”. If it is deemed necessary for a patient to have ESWT, it should be done as a self-pay service.