Does Medicare Cover PTNS?

About

Medicare 101

Current Clients

Does Medicare Cover PTNS?

Diagnosis overactive bladder stock image

By Daniel Petkevich

Dec 9, 2022

Treat your overactive bladder

Finding the proper treatment for your overactive bladder can be challenging. If you are looking for a minimally invasive procedure, PTNS might be right for you. And the good news is Medicare will cover you for PTNS if it's deemed medically necessary. Let's talk more about what PTNS entails.

Stay Up to Date on Medicare!

What is PTNS?

Percutaneous Tibial Nerve Stimulation (PTNS) is a minimally invasive treatment to help relieve overactive bladder symptoms, including urinary urgency and frequency. PTNS works by stimulating the nerves in your lower legs that control the bladder muscles. A small needle is inserted under the skin of your ankle and connected to a device that sends electrical pulses. These pulses help relax the bladder muscles and can reduce symptoms of an overactive bladder, like urgency and frequency of urination.

To be eligible for coverage under Medicare, you must meet certain criteria. To be covered, your doctor must determine that you have symptoms of overactive bladder, and they must certify that other treatments (such as medications) have not been effective. Additionally, the service must be provided by a Medicare-approved provider in order for it to be covered.

How does Medicare cover PTNS?

Medicare will cover PTNS if it's deemed medically necessary. This means that your doctor must agree that this treatment is the best option for relieving your symptoms and that there are no other treatments available. In addition, you must meet certain criteria, including having failed trials of conservative therapies such as lifestyle changes or medications. In some cases, Medicare may also cover PTNS if it's considered medically necessary to improve quality of life.

If you are approved for Medicare coverage, you will typically receive 80% of the cost after you have met your deductible. You'll be responsible for up to 20% of the remaining cost out-of-pocket, depending on your plan. For example, if you have

Medicare Supplement Plan G

, you will only be responsible for the Part B deductible.

What are the benefits of PTNS?

PTNS is a safe and effective treatment for an overactive bladder that can help reduce urinary urgency and frequency. It has been found to have few side effects, is non-invasive, and does not require any medications or surgery. Additionally, patients report improved quality of life after undergoing the treatment.

Are there any risks associated with PTNS?

Although PTNS is generally a safe treatment, there are some minor risks associated with it. The most common side effects include temporary pain or discomfort in the lower legs where the stimulation takes place and mild tingling sensations in the bladder area. In rare cases, patients may experience an increase in symptoms or even urinary

How to get started with PTNS therapy?

If you think that PTNS might be a good treatment option for your overactive bladder, the first step is to speak with your doctor. Your doctor can evaluate you and determine if PTNS is the right choice for you. After they approve the treatment, they will refer you to a qualified provider who can then start the process of providing PTNS therapy.

Once you have started the treatment, your provider will be able to help you determine how often and for how long you should receive PTNS sessions in order to get the most benefit from them. With the right care and dedication, PTNS can help reduce or even eliminate symptoms of an overactive bladder so that you can live a better life.

Takeaway

If you have questions about PTNS, please contact your doctor or insurer for more information. They can help provide answers and assistance so that you can make the best decision for your health needs. This content is for informational purposes only. If you have questions about your Medicare coverage, give us a call at Fair Square Medicare. We'll connect you with an expert today.

Stay Up to Date on Medicare!

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

888-572-6033

info@fairsquaremedicare.com

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

•

Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M

Does Medicare Cover PTNS?

Treat your overactive bladder

Stay Up to Date on Medicare!

What is PTNS?

How does Medicare cover PTNS?

What are the benefits of PTNS?

Are there any risks associated with PTNS?

How to get started with PTNS therapy?

Takeaway

Stay Up to Date on Medicare!

Recommended Articles

More of our articles

Your Medicare One-Stop-Shop

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans