Does Medicare cover cold laser therapy (CLT)?
Pain reduction treatment options such as cold laser therapy provide much-needed relief. Does Medicare cover cold laser therapy? CMS has determined that low-level laser therapy is not covered for treatment of specific diagnoses or pain due to certain conditions. Read on to learn about under what conditions Medicare covers cold laser therapy.
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Laura D. Adams
Insurance & Finance Analyst
Laura Adams is one of the nation’s leading finance, insurance, and small business authorities. As an award-winning author, spokesperson, and host of the top-rated Money Girl podcast since 2008, millions of readers and listeners benefit from her practical advice. Her mission is to empower consumers to live healthy and rich lives by planning for the future and making smart money decisions. She rec...
Insurance & Finance Analyst
UPDATED: Dec 22, 2024
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UPDATED: Dec 22, 2024
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Low-level laser therapy, also called cold laser therapy, is non-covered as skilled therapy services
- Cold laser therapy is a relatively new and non-invasive treatment option for pain with incomplete information for optimal treatment protocols
- Other insurance options are available if you need cold laser therapy coverage
Whether you want cold laser therapy on Medicare or already receive cold laser therapy and want Medicare coverage, you need to understand the requirements needed to get your insurance to pay for cold laser therapy.
Does Medicare cover cold laser therapy? Any service must meet Medicare’s guidelines for reasonable and necessary treatment. Outpatient therapy coverage guidelines have basic requirements in common.
Medicare lists cold laser therapy to be a non-covered skilled therapy service. Without much work from your healthcare provider and their team, Medicare won’t cover cold therapy treatment.
There are many different health insurance groups and coverages available to buy. If you specifically need cold laser therapy coverage, there are options available for you.
Grab your free Medicare insurance quotes by entering your ZIP code today.
Does Medicare cover cold laser therapy?
Medicare is a defined benefit program. An item or service must fall within a benefit category as a prerequisite to Medicare coverage.
The Centers for Medicare & Medicaid Services (CMS) evaluates relevant clinical evidence to determine whether or not the evidence is of sufficient quality to support a finding that an item or service is reasonable and necessary for the diagnosis or treatment of a patient.
An improved health outcome is one of several considerations in determining whether an item or service is reasonable and necessary.
Infrared therapy devices may fall within the benefit category of durable medical equipment. Infrared therapy also may be provided as services and supplies furnished incident to a physician’s service.
Even hospital services incident to a physicians’ services rendered to outpatients and outpatient physical therapy services may have documentation allowing coverage in unique patient situations.
The treatment plan should strive to provide treatment in the most efficient and effective way, balancing the best achievable outcome with the appropriate resources.
Therefore, the CMS concluded that infrared devices are not reasonable and necessary for the treatment of Medicare beneficiaries for diabetic and non-diabetic peripheral sensory neuropathy, wounds and ulcers, and similar related conditions, including symptoms such as pain from these conditions.
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What is cold laser therapy?
Cold laser therapy is a non-invasive procedure for pain relief that does not require a surgical incision or medications. There are no prolonged recovery times and no serious side effects when used properly by a doctor.
It can be used alone or with other treatment options. Medicare covers alternative medicine that also avoids surgical incisions or medications.
When applied to the skin, these lasers produce no sensation and do not burn the skin. Due to the low absorption by the skin, it’s hypothesized that laser light penetrates deeply into the tissues.
The exact mechanisms of its effect on tissue healing are unknown.
Is cold laser therapy the same as low-level laser therapy?
Low-level laser therapy can also be called photobiomodulation, cold lasers, or non-thermal lasers. It refers to the use of red-beam or near-infrared lasers.
What are the benefits of cold laser therapy?
Cold laser therapy can be used independently or in combination with other treatment options. Patients seeking pain relief or pain reduction without surgery or medications will appreciate cold laser therapy.
It is a viable treatment option for certain types of pain by most health care professionals. Adding this method among other tools to help with pain relief can increase results.
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Why should I not consider cold laser therapy?
Cold laser therapy is a new treatment option. There is incomplete information about its optimal treatment protocol.
It requires a series of usually 8-30 treatments for pain relief or the resolution of pain symptoms. Treatments occur 2-4 times per week, and old injuries may be aggravated for several days after treatment.
Medicare and Medicaid do not cover cold laser therapy expenses. However, other major medical insurance companies do have coverage options.
Cold laser therapy shouldn’t be used with any carcinoma, or suspicious cancerous lesions, over the thyroid, or with known or suspected pregnancies. The laser should also be kept away from the eyes.
Do you need cold laser therapy treatment but need additional affordable Medigap insurance rates? Enter your ZIP code to receive your free quotes today.
Case Studies: Medicare Coverage for Cold Laser Therapy
Case Study 1: John’s Experience With Cold Laser Therapy
John, a Medicare beneficiary, suffers from chronic knee pain due to arthritis. Seeking relief, he explores the option of cold laser therapy. However, he discovers that Medicare does not cover this treatment for arthritis-related pain. John decides to explore other pain reduction options covered by Medicare.
Case Study 2: Sarah’s Success With Cold Laser Therapy
Sarah, a Medicare beneficiary, has been diagnosed with carpal tunnel syndrome. Her healthcare provider recommends cold laser therapy as a non-invasive treatment option. Sarah’s Medicare coverage includes this therapy for carpal tunnel syndrome. She undergoes the recommended sessions and experiences a significant reduction in pain and improved hand functionality.
Case Study 3: Mark’s Disappointment With Cold Laser Therapy
Mark, a Medicare beneficiary, suffers from chronic lower back pain. After researching various treatment options, he decides to try cold laser therapy. However, Mark’s healthcare provider informs him that Medicare does not cover cold laser therapy for back pain. Mark explores other pain management options covered by Medicare to find a suitable solution.
Read more: Does Medicare cover back surgery?
Frequently Asked Questions
What is Cold Laser Therapy (CLT)?
Cold Laser Therapy (CLT) is a non-invasive treatment that uses low-level light to stimulate healing in damaged tissues and reduce pain and inflammation.
Does Medicare cover Cold Laser Therapy?
Yes, Medicare does cover Cold Laser Therapy (CLT) for certain conditions when deemed medically necessary and appropriate by a healthcare provider.
Is Cold Laser Therapy safe?
Yes, Cold Laser Therapy is generally considered safe when administered by a trained healthcare provider.
How is Cold Laser Therapy administered?
Cold Laser Therapy is administered through a handheld device that emits low-level light energy onto the affected area.
Can I appeal if my Cold Laser Therapy claim is denied by Medicare?
Yes, if your Cold Laser Therapy claim is denied by Medicare, you have the right to appeal the decision. The appeals process allows you to provide additional information or evidence to support your case.
Can I receive Cold Laser Therapy if I have a supplemental insurance plan alongside Medicare?
Yes, if you have a supplemental insurance plan, also known as Medigap, it may provide additional coverage for Cold Laser Therapy. The coverage details can vary depending on your specific Medigap plan.
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Laura D. Adams
Insurance & Finance Analyst
Laura Adams is one of the nation’s leading finance, insurance, and small business authorities. As an award-winning author, spokesperson, and host of the top-rated Money Girl podcast since 2008, millions of readers and listeners benefit from her practical advice. Her mission is to empower consumers to live healthy and rich lives by planning for the future and making smart money decisions. She rec...
Insurance & Finance Analyst
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.