Does Medicare Cover Wound Care Supplies? Coverage Guidelines
Will Medicare pay for wound care supplies?
The Quick Answer
**Yes—Medicare Part B covers surgical dressings** (including gauze, transparent films, hydrocolloids) for qualifying wounds: surgical wounds until epithelialization, wounds requiring debridement, or chronic wounds with measurable exudate. Coverage requires physician documentation of wound characteristics and monthly reassessment. NPWT (wound VAC) is covered when conventional therapy fails for diabetic/pressure ulcers or dehisced surgical wounds.
Why We Ask This
Beneficiaries face unexpected out-of-pocket costs after assuming 'Medicare covers everything,' not realizing documentation requirements (wound measurements, exudate levels) must be meticulously maintained—or that supplies for 'moisture-associated skin damage' without open wounds are excluded.
The Practical Science
Medicare defines 'surgical dressings' as items maintaining a moist wound environment while absorbing exudate. Coverage requires: 1) qualifying wound present, 2) appropriate dressing type matched to exudate level, 3) physician order with frequency, and 4) supplier enrolled in Medicare DME program. NPWT requires additional prior authorization demonstrating failed standard care.
In Clinical Practice
A Medicare beneficiary with a stage 3 pressure ulcer receives covered alginate dressings (high exudate) changed 3x/week—documented by home health nurse with weekly wound measurements showing 20% area reduction. After 4 weeks of stalled progress, NPWT authorization is approved based on documented treatment failure with conventional dressings.
References & Context
Medicare Guidelines for Wound Care Supplies - CHC Solutions"Medicare refers to wound care supplies as "surgical dressings." Surgical dressings are covered when a qualifying wound is present. A qualifying wound is defined as either of the following: A wound caused by or treated by a surgical procedure. A wound that requires debridement, regardless of the debridement technique."