New Contractual Policy

New Contractual Policy for Compression Stockings

Independent Health is implementing a new contractual policy for coverage for compression stockings. This new policy will apply to our Medicare line of business only and be effective November 1, 2015. The new policy will be posted at under Policies beginning October 1, 2015.

Our coverage will now align with the Centers for Medicare & Medicaid Services (CMS) coverage and limit the types and quantity of stockings that are covered. In addition, custom-made stockings will not be covered. Below are some details on codes related to the policy:

  • A6531, A6532, A6534 and A6535 will be covered for Medicare Advantage members. The quantity will be limited to 12 stockings per calendar year.
  • A6530, A6533, A6536, A6537, A6539, A6540 and A6549 are not covered for all indications because they do not meet the definition of a surgical dressing.

This change will not apply to group Medicare plans until January 1, 2016. Please refer to the patient information section on HealtheNet to determine individual versus group status. In HealtheNet, Medicare individual plans return with the group name “Medicare Individual Plans” and group plans will return the name of the employer group.

If you have any questions, please contact our Provider Service department by calling (716) 631-3282 or 1-800-736-5771, Monday through Friday from 8 a.m. to 6 p.m.