Does Medicare Cover PTNS?
Fair Square Medicare

Does Medicare Cover PTNS?

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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.

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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.

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Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.


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