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does Medicare cover laser back surgery

Does Medicare Cover Laser Back Surgery?

Few things can be as crippling as a back pain. It’s something that can affect young and old alike. However, as we age, issues such as spinal stenosis and even osteoarthritis only add to the risk of developing back pain.

There are many types of treatments for back pain. Sometimes they work, sometimes they don’t. If your back pain gets really bad and nothing seems to help, your doctor may recommend laser back surgery. 

If your doctor suggests this treatment option to you, a common question you may have is “does Medicare cover laser back surgery?” In this article, we answer that question in clear, plain English. You will also find the average costs of laser back surgery (as you’ll see, it is not cheap!).

Does Medicare Cover Laser Back Surgery?

The short answer is yes. Medicare will cover the cost of laser back surgery. But not 100% of the time. As is usually the case with Medicare, certain conditions have to be met in order for Medicare to pay for your laser back surgery. Below we take a closer look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for laser back surgery. This is because laser back surgery is considered a medically necessary treatment. However, the operation must first be ordered by your healthcare provider to get Original Medicare to provide coverage for your surgery. 

Coverage for laser back surgery is provided by Medicare Part A if it takes place in an inpatient setting. In addition to the surgery itself, Medicare Part A will provide coverage for the following hospital services related to your surgery such as:

  • General nursing
  • Semi-private room
  • Meals
  • Other hospital services and supplies

Medicare Part A will cover 100 percent of the costs of hospital stays for up to 60 days. There are copays for hospital stays that last longer than 60 days. However, for a laser back surgery it’s rare to have a hospital stay of more than a days, and extremely rare to have one last 60 days or more.

It is possible to have outpatient laser spine surgery too. In this case, coverage will fall under Medicare Part B. Medicare Part B may also provide coverage for medically necessary services related to your laser back surgery such as MRI tests, post-operative exams, and physical therapy.

Once approved, Medicare Part B covers 80 percent of the costs of laser back surgery. You will pay for the remaining 20 percent. 

Part C Coverage for Laser Back Surgery

Medicare Advantage plans (Medicare Part C) also provide coverage for laser back surgery. Advantage plans must cover the same treatments and services that Original Medicare covers. But these plans will also offer benefits that Original Medicare does not. Exactly what these benefits are and how much your out-of-pocket costs will be for them will depend on the plan.

How Much Does Laser Back Surgery Cost?

A laser spine surgery may range anywhere from $6,000 to over $70,000, depending on the type of procedure and what’s causing your back pain. Simpler laser back surgery procedures usually range from $6,000 to $20,000. More complex procedures typically range somewhere from $20,000 to $70,000 on average.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover food allergy testing?

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