Therapeutic phlebotomy is a procedure that uses a needle to take the patient’s blood from their vein. Most often from the patient’s arm. Blood draw or venipuncture are other names for this procedure. 

If this procedure is one that you need, you are probably wondering “does Medicare cover therapeutic phlebotomy?” In this article, we answer that question in clear, plain English. Plus learn more about the costs of this procedure and some helpful background information about it.

Does Medicare Cover Therapeutic Phlebotomy?

The short answer is no. In most cases, Medicare will not cover the cost of your treatment for therapeutic phlebotomy. 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 therapeutic phlebotomy. 

Original Medicare

Original Medicare (Medicare Part A and Part B) may not provide coverage for therapeutic phlebotomy. As of now, there is no sufficient data on whether Original Medicare provides coverage for therapeutic phlebotomy or not. Medicaid also does not have enough data for this procedure. 

However, if you need this procedure for diagnostic purposes, you can undergo blood tests instead. Original Medicare provides coverage for blood tests as long as they are medically necessary.

Coverage for blood tests is provided by Medicare Part A if it takes place in an inpatient setting such as hospitals. On the other hand, coverage for blood tests is provided by Medicare Part B if it takes place in an outpatient setting. 

Part C Coverage for Therapeutic Phlebotomy

Just like with Original Medicare, there is also not enough data to know whether Medicare Advantage plans provide coverage for treatment for therapeutic phlebotomy or not. These plans have to cover everything that Original Medicare covers and will also cover additional treatments and services. Which additional treatments and services they cover and what the costs for the plans are will vary depending on the plan you choose.

How Much Does Therapeutic Phlebotomy Cost?

The national average cost of therapeutic phlebotomy is $305. There are some outside organizations that can help cover the costs.

What Is Therapeutic Phlebotomy?

Therapeutic Phlebotomy is a procedure that takes blood from the patient’s vein through the use of a needle. This procedure can be for diagnosing different kinds of medical conditions. But aside from diagnosis purposes, therapeutic phlebotomy can also be used as a treatment for certain medical conditions. 

What Medical Conditions Can Therapeutic Phlebotomy Treat?

As said earlier, therapeutic phlebotomy is a medical procedure not just for diagnosis purposes, but also for the treatment of certain medical conditions. Here are some of the medical conditions that therapeutic phlebotomy is said to treat:

  • Hemochromatosis
  • Sickle cell disease
  • Nonalcoholic fatty liver disease
  • Polycythemia vera

Therapeutic phlebotomy is also used to remove extra red blood cells, mainly the red blood cells that bear an unusual shape. 

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 exercise programs?

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