Is Emsella Covered by Medicare?
Fair Square Medicare

Is Emsella Covered by Medicare?

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By Daniel Petkevich

Nov 21, 2022

You might finally have coverage

For many Medicare beneficiaries, incontinence is a difficult symptom to try to overcome. Pelvic floor stimulation has been a popular treatment for incontinence in recent years. While this wasn't always the case, Emsella and other pelvic floor physiotherapy treatments are now covered by Medicare. There are a few conditions though; let's dig into Medicare coverage of Emsella.

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What is Emsella and how does it work?

Emsella is a non-invasive, electromagnetic stimulation therapy designed to strengthen the pelvic floor muscles. This treatment finds and stimulates all of the muscles in the pelvic floor at once using high-intensity focused electromagnetic (HIFEM) technology. During an Emsella session, patients sit on a chair that emits these electrical pulses, stimulating the pelvic floor muscles with each pulse.

How is pelvic floor stimulation treatment covered by Medicare?

Medicare Part B covers Emsella sessions for adults with urinary or fecal incontinence. The coverage also applies to other pelvic floor stimulation treatments, such as neuromodulation and electrostimulation of the pelvic floor. In order to be eligible, patients must meet certain criteria, including having had at least three trials of non-surgical treatment for incontinence, being free of urinary tract infection, and having had a pelvic floor muscle assessment.

Medicare Advantage plans may offer additional coverage for treatments like Emsella, but it is important to check with your provider to see what is covered.

It's also important to note that Emsella sessions can be expensive, ranging from $200-$600 per session. With Medicare Part B, you will be responsible for 20% of the total cost. In some Medicare Supplement plans, that 20% will be covered in addition to other out-of-pockect costs.

Medicare does not cover the cost of evaluation or examinations before or after the treatments.

What are the conditions that must be met for Medicare to cover Emsella?

In order for Medicare to cover Emsella, patients must meet the following criteria:

  • Have had at least three trials of non-surgical treatment for incontinence

  • Be free of urinary tract infections

  • Have had a pelvic floor muscle assessment

Medicare Advantage plans may offer additional coverage for treatments like Emsella, but it is important to check with your provider to see what is covered.

How can beneficiaries find a provider who offers Emsella treatment?

If you are considering treatment for incontinence using pelvic floor stimulation therapy, it is important to talk to your doctor or healthcare provider. They can provide advice and guidance on the best course of treatment for your individual needs and help you find a qualified provider who offers Emsella treatments.

Are there any risks associated with pelvic floor stimulation treatments?

As with any medical treatment, there are risks associated with pelvic floor stimulation therapies like Emsella. Patients may experience mild discomfort during the treatment and some temporary muscle soreness afterward. Other possible side effects include skin irritation, dizziness, nausea or headaches.

Conclusion

Emsella is a non-invasive pelvic floor stimulation therapy that can be used to treat urinary or fecal incontinence. Medicare Part B covers Emsella sessions for eligible patients, and Medicare Advantage plans may offer additional coverage. Talk to your doctor if you are interested in seeking treatment for your incontinence to see if Esmella is right for you. This content is for informational purposes only. Speak with a Medicare expert at Fair Square Medicare if you have questions about your coverage at 1-888-376-2028.

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