Does Medicare Cover Carpal Tunnel Syndrome Surgery?
This article was updated on: 09/12/2018
The National Institute of Neurological Disorders and Stroke (NINDS) notes that common symptoms of carpal tunnel syndrome include numbness, weakness, burning, tingling or sometimes pain in the hand and wrist. As symptoms worsen, you may have trouble grasping objects. Sometimes carpal tunnel surgery may be necessary.
When might carpal tunnel surgery be necessary?
You might not need carpal tunnel surgery; there are various ways to treat carpal tunnel syndrome. The Mayo Clinic recommends that carpal tunnel treatment start as soon as the symptoms appear. Early intervention may provide relief and slow carpal tunnel syndrome’s progression. Your doctor may suggest you rest your hands, avoid activities that aggravate the symptoms, if possible, and apply cold packs to reduce swelling.
If your condition is diagnosed early, non-surgical carpal tunnel treatment options may help to relieve your pain – and you might be able to avoid carpal tunnel surgery. As the Mayo Clinic notes, non-surgical treatments often reduce the discomfort associated with mild or moderate symptoms. Consult your doctor before trying any of these. Examples of carpal tunnel treatments include:
- Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- Using a wrist splint when you are at rest to help relieve symptoms of tingling and numbness
- Getting doctor-administered corticosteroid (such as cortisone) injections into your carpal tunnel to relieve pain
If these treatments don’t relieve your pain, your doctor may recommend carpal tunnel surgery to cut the ligament pressing on the median nerve that is causing pain. Carpal tunnel surgery may be performed as an endoscopic procedure or an open surgical procedure. You may want to discuss the benefits and risks of each with your doctor if you are considering carpal tunnel surgery.
Does Medicare cover carpal tunnel surgery or treatment?
Usually Medicare Part A and Part B don’t cover over-the-counter medications, including those that you may take to reduce the pain and swelling associated with carpal tunnel syndrome. However, Medicare Part B might cover corticosteroid injections administered in your doctor’s office as carpal tunnel treatment. Under the durable medical equipment benefits of Medicare Part B, you might have coverage for a wrist splint prescribed by your doctor as carpal tunnel treatment. Medicare Part B may cover outpatient surgeries, including carpal tunnel surgery.
If you need carpal tunnel surgery as a hospital inpatient, Medicare Part A may cover the surgery and medically necessary hospital care, along with any medications given to you as an inpatient to treat your condition.
Medicare may help pay for your carpal tunnel treatment, including carpal tunnel surgery, if medically necessary and delivered by providers who accept Medicare assignment. Unless you have a Medicare Supplement plan or other coverage, you are generally responsible for the approved amount that Medicare does not pay for carpal tunnel treatment, such as the Medicare deductible and coinsurance or copayment. Your cost share for carpal tunnel treatment may be different if you receive your Medicare benefits from a Medicare Advantage plan.
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