Does Medicare Cover Gastric Sleeve Surgery?
Recently, The Centers of Medicare and Medicaid Services (CMS) decided to allow gastric sleeve (sleeve gastrectomy) to be covered by Medicare administrators on a case by case basis.
The CMS has confirmed the removal of the Non-Covered status indicator for Sleeve Gastrectomy beginning October 1, 2012. This means that if a patient meets qualifications for this weight loss surgery procedure they may now have the opportunity to have this procedure covered by Medicare.
In order to potentially qualify the CMS has stated that all of the following criteria must be met when seeking gastric sleeve surgery:
- The beneficiary has a body-mass index (BMI) > 35 kg/m2,
- The beneficiary has at least one co-morbidity related to obesity, and
- The beneficiary has been previously unsuccessful with medical treatment for obesity.