CLINICAL

This topic covers biophysical agents used to treat wounds. Interventions include electromagnetic stimulation (ES), pulsed electromagnetic field therapy (EMT/PEMF), diathermy, therapeutic ultrasound and phototherapy. Negative pressure wound therapy and hyperbaric oxygen therapy are discussed separately. (See topics "Negative Pressure Wound Therapy", and  "An Introduction to Hyperbaric Oxygen Therapy"). This topic will be expanded to include clinical information soon. A list of Medicare national and local coverage determinations can be found under section 'Coding, Coverage and Reimbursement' below.

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CODING, COVERAGE AND REIMBURSEMENT

Relevant Medicare National Coverage Determinations

• National Coverage Determination (NCD) for Infrared Therapy Devices (270.6) [1] 
• National Coverage Determination (NCD) for Noncontact Normothermic Wound Therapy (NNWT) (270.2) [2]
• National Coverage Determination (NCD) for Electrical Stimulation (ES) and Electromagnetic Therapy for the Treatment of Wounds (270.1) [3]
  

Medicare Administrative Contractors and Local Coverage Determinations

Medicare coverage of provider and facility fees related to application of CTPs is managed by Medicare Administrative Contractors (MAC), under Medicare Part A or Part B. Each jurisdiction may have its own specific local coverage determination and policies, as follows:

• Novitas Solutions, Inc.
• • Local Coverage Determination (LCD): Wound Care (L35125), Revision Effective Date 07/23/2020 [4]
    
• CGS Administrators, LLC:
• • Local Coverage Determination (LCD): Outpatient Physical and Occupational Therapy Services (L34049), Revision Effective Date 06/04/2026 [5]
  • Local Coverage Determination (LCD): Outpatient Physical Therapy (L34428), Revision Effective Date 05/18/2023 [6]
  • Local Coverage Article: Low frequency, non-contact, non-thermal ultrasound (CPT code 97610) (A56175), Revision Effective Date 03/05/2026 [7]
• Palmetto:
• Local Coverage Determination (LCD): Home Health Physical Therapy (L34564), For services performed on or after 05/23/2024 [8]
• Local Coverage Determination (LCD): Outpatient Occupational Therapy (L34427), Revision Effective Date 04/13/2023 [9]
• Local Coverage Determination (LCD): Outpatient Physical Therapy (L34428), Revision Effective Date 05/18/2023 [6]
• Local Coverage Article: Low frequency, non-contact, non-thermal ultrasound (CPT code 97610) (A54555), Revision Effective Date 01/01/2024 [10]
• Local Coverage Article: Low frequency, non-contact, non-thermal ultrasound (CPT code 97610) (A53773), Revision Effective Date 01/01/2024 [11]
• Billing and Coding: Topical Oxygen Therapy (A56431) [12] 
• Topical Oxygen Therapy (L37873) [13]
• First Coast Service Options, Inc. (FCSO):
• • Local Coverage Determination (LCD): Wound Care (L37166), Revision Effective Date 07/23/2020 [14]
    
• National Government Services, Inc. (NGS): 
• Local Coverage Determination (LCD): Outpatient Physical and Occupational Therapy Services (L33631), For services performed on or after 04/01/2026 [15]
  
• Noridian:
• Local Coverage Determination (LCD): Wound and Ulcer Care (L38902), Revision Effective Date 11/28/2021 [16]
• Billing and Coding: Topical HBO and Physician Related Service Billing and Coding Guidelines (A56025) [17]
• Wisconsin Physicians Service Insurance Corporation (WPS):
• Local Coverage Determination (LCD): Wound Care (L37228), Revision Effective Date 03/27/2025 [18]