Medicare CPM Machine Coverage
- CPM machines are often utilized following surgery to help reduce joint stiffness, and Medicare may cover CPM machines if certain criteria are met. Learn more.
Continuous passive motion machine therapy, or CPM, is often prescribed following knee or hip surgery as a way to help reduce pain and swelling and build back range of motion in the joints. CPM machine therapy is especially helpful to individuals recovering from extensive procedures, as the machines help move the joints and muscles without causing extra strain on the body. CPM machines work to stimulate blood and fluid movement post-surgery, which can help improve flexibility during the recovery process. Read on to learn whether Medicare covers CPM machine therapy.
Does Medicare Cover CPM Machine Therapy?
If CPM machine therapy is considered medically necessary, Medicare may provide coverage for a limited period of time. Generally, coverage for CPM machine therapy is provided for up to 21 days, with the coverage date starting the day after the Medicare recipient is released from the hospital.
Medicare generally considers any type of CPM machine therapy recommended for over 21 days as investigational and not medically necessary. Individuals seeking coverage under Medicare for CPM machine therapy must rent their machines from suppliers participating in the Medicare program.
Once recipients meet the Medicare criteria, they're typically responsible for 20% of CPM machine rental costs, while Medicare covers the remaining 80%. Individuals with supplemental Medigap or Medicaid may be eligible for additional coverage, so it's always a good idea to verify all out-of-pocket costs with plan providers.
How Much Do CPM Machines Cost?
While specific prices may vary depending on the supplier, CPM machines typically cost $300 to $425 for 3-week rentals and $100 per week for all subsequent weeks. When purchased outright, CPM machines can cost up to $2,000. For Medicare recipients without supplemental coverage who rent the machines for 21 days, approximate out-of-pocket costs should range between $60 and $85.
How Do CPM Machines Work?
CPM machines are commonly prescribed following knee, hip, elbow and lower back surgeries. The machines attach directly to the limbs and operate via push buttons or remote controls. When in use, CPM machines move the affected joints through range of motion exercises. Users can control settings, such as speed and passive motion duration, to suit their specific comfort levels, and the machines are designed with special frames to conform to each user's body.
Why Have Some Surgeons Stopped Prescribing CPM Machines?
While research has shown the benefits of CPM therapy in certain situations, some medical professionals feel the machines should not be prescribed following total knee replacement procedures. This is due to new studies that indicate CPM machines don't aid in improving full range of motion for total knee replacement recipients.
However, additional studies have shown that CPM therapy may be beneficial when started early in treatment regimens and following ACL reconstruction construction procedures. Since the results of CPM therapy can vary on a case-by-case basis, individuals should consult with their physicians regarding potential outcomes and benefits.