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Does Medicare Cover Shock Wave Therapy

Does Medicare Cover Shock Wave Therapy?

Does Medicare Cover Shock Wave Therapy?

Extracorporeal shock wave therapy, also known as ESWT, has emerged as a potential therapy option for various musculoskeletal conditions. 

If you are considering this treatment, you may wonder, “Does Medicare cover Shock Wave Therapy?”

In this article, we answer the question in plain English. You will also find some additional information about this treatment, its costs and insurance coverage that you should find helpful.

Does Medicare Cover Shock Wave Therapy?

In most cases, the answer is no. Medicare will not cover the cost of shock wave therapy. Although with that said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your shock wave therapy. 

Original Medicare Coverage of Shock Wave Therapy

Original Medicare (consisting of Part A and Part B) does not provide coverage for shock wave therapy unless it is performed for a medically necessary reason.

If the purpose of shock wave therapy is to preserve life and treat a serious health condition, then it is possible you may be able to receive coverage.

In most cases, however, if you choose to try out ESWT, you will have to pay 100 percent of the costs. Again, Medicare does not provide coverage for procedures if they are done for non-medically necessary reasons.

But what about other Medicare plans?

Medicare Advantage Coverage of Shock Wave Therapy

Similarly, Medicare Advantage plans (Medicare Part C) also do not cover shock wave therapy. These plans cover the same things Original Medicare covers but goes above and beyond to provide coverage for some treatments Original Medicare does not cover.

Exactly what a Medicare Advantage plan covers and how much your out-of-pocket costs are will vary depending on your plan.

How Much Does Shock Wave Therapy Cost?

The average cost of shockwave therapy is $300. However, the costs of shock wave therapy may either be higher or lower than that. However, it will usually fall between $250 and $400. 

More information on Extracorporeal Shock Wave Therapy

ESWT can be used regularly to treat many physical conditions.

  • Calcific tendinopathy of the shoulder, 
  • Elbow tendinopathy (lateral/medial epicondylitis), 
  • Carpal tunnel syndrome (CTS), 
  • Greater trochanteric pain syndrome (GTPS), 
  • Fractures and delayed unions/nonunions,
  • Osteonecrosis of the femoral head (ONFH), 
  • Erectile dysfunction (ED)
  • Patellar tendinopathy (PT.) 

How Does Extracorporeal Shock Wave Therapy Relieve Pain?

ESWT is a type of therapy that relieves pain in the areas treated. But how does it do this exactly?

A lot of research suggests that ESWT relieves pain in the following ways: 

  • It disrupts fibrous tissue, allowing for tissue revascularization and healing.
  • The shock waves’ direct and indirect effects on cell membranes may reduce nociceptors’ ability to send pain signals and improve healing.
  • Shock waves reduce pain and improve function by breaking up calcium deposits, loosening structures, and promoting calcium resorption.

Does Other Health Insurance Cover Shock Wave Therapy For ED

The short answer to that is no. Other well-known health insurance companies such as Aetna, Cigna, United Healthcare, and AARP do not provide coverage for shock wave therapy for treating erectile dysfunction.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always 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 Lyme Disease Testing?

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