Medicare National Coverage Determinations (NCD) Manual (Pub. 100-03), Ch. 1 § 30.1.1
Biofeedback Therapy for the Treatment of Urinary
30.1.1 - Biofeedback Therapy for the Treatment of Urinary
Incontinence
(Rev. 1, 10-03-03)
CIM 35-27.1
Biofeedback Therapy for the Treatment of Urinary Incontinence
This policy applies to biofeedback therapy rendered by a practitioner in an office or other
facility setting.
Biofeedback is covered for the treatment of stress and/or urge incontinence in cognitively
intact patients who have failed a documented trial of pelvic muscle exercise (PME)
training. Biofeedback is not a treatment, per se, but a tool to help patients learn how to
perform PME. Biofeedback-assisted PME incorporates the use of an electronic or
mechanical device to relay visual and/or auditory evidence of pelvic floor muscle tone, in
order to improve awareness of pelvic floor musculature and to assist patients in the
performance of PME.
A failed trial of PME training is defined as no clinically significant improvement in
urinary incontinence after completing four weeks of an ordered plan of pelvic muscle
exercises to increase periurethral muscle strength.
Contractors may decide whether or not to cover biofeedback as an initial treatment
modality.
Home use of biofeedback therapy is not covered.