Medicare Wound Care Guidelines

Medicare covers wound care supplies or surgical dressings when they are medically necessary. Medicare will pay for 80 percent of the cost after you meet your deductible. You will also pay a copayment if you receive treatment in a hospital outpatient setting.

Christian Simmons, writer and researcher for RetireGuide
  • Written by
    Christian Simmons

    Christian Simmons

    Financial Writer

    Christian Simmons is a writer for RetireGuide and a member of the Association for Financial Counseling & Planning Education (AFCPE®). He covers Medicare and important retirement topics. Christian is a former winner of a Florida Society of News Editors journalism contest and has written professionally since 2016.

    Read More
  • Edited By
    Lee Williams
    Lee Williams, senior editor for RetireGuide.com

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

    Read More
  • Published: June 30, 2021
  • Updated: September 16, 2022
  • 3 min read time
  • This page features 8 Cited Research Articles
Fact Checked
Fact Checked

Our fact-checking process starts with vetting all sources to ensure they are authoritative and relevant. Then we verify the facts with original reports published by those sources, or we confirm the facts with qualified experts. For full transparency, we clearly identify our sources in a list at the bottom of each page.

Cite Us
How to Cite RetireGuide.com's Article

APA Simmons, C. (2022, September 16). Medicare Wound Care Guidelines. RetireGuide.com. Retrieved September 27, 2022, from https://www.retireguide.com/medicare/treatments/wound-care/

MLA Simmons, Christian. "Medicare Wound Care Guidelines." RetireGuide.com, 16 Sep 2022, https://www.retireguide.com/medicare/treatments/wound-care/.

Chicago Simmons, Christian. "Medicare Wound Care Guidelines." RetireGuide.com. Last modified September 16, 2022. https://www.retireguide.com/medicare/treatments/wound-care/.

Why Trust RetireGuide.com
Why You Can Trust Us

Content created by RetireGuide and sponsored by our partners.

Key Principles

RetireGuide’s mission is to provide seniors with resources that will help them reach important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement.

We’re dedicated to providing thoroughly researched Medicare information that guides you toward making the best possible health decisions for you and your family.

RetireGuide LLC has partnerships with Senior Market Sales (SMS) and GoHealth.

Our partners are able to be reached through the phone numbers and/or forms provided on our website.

The content and tools created by RetireGuide adhere to strict Medicare and editorial guidelines to ensure quality and transparency.

Editorial Independence

While the experts from our partners are available to help you navigate various Medicare plans, RetireGuide retains complete editorial control over the information it publishes.

We operate independently from our partners, which allows the award-winning RetireGuide team to provide you with unbiased information.

Visitors can trust our inflexibility regarding our editorial autonomy. We do not allow our partnership to influence RetireGuide’s editorial content whatsoever.

When Does Medicare Cover Wound Care Supplies?

Wound care supplies are covered in some circumstances. Treatment covered under Medicare must be medically necessary and used for a surgical or surgically treated wound.

You pay nothing for the actual supplies but must meet the Part B deductible. After meeting the deductible, you will be responsible for 20 percent of the cost of treatment as well as a copayment if you receive care in a hospital outpatient setting.

Types of Wounds That Medicare Covers
  • Surgical wounds that must be left open
  • Infected open wounds that result from surgery or trauma
  • Biofilm wounds
  • Autoimmune disorder wounds
  • Necrotic tissue wounds

Wound care is usually for injuries that do not improve independently or take an unusually long time to heal.

According to the U.S. National Library of Medicine, this typically includes a wound that has not healed within six weeks or at least started to heal after two weeks.

Medicare Part A covers care if you are an inpatient at a hospital or a skilled nursing facility. Wound care could be covered under Part A as well, but only under these circumstances.

Remember that just because you are staying in a hospital does not mean that you are automatically an inpatient. Check with your doctor to determine your patient status if you plan to receive treatment in a hospital.

Wound Care Supplies Covered by Medicare

Medicare covers wound care dressings for injuries treated by a surgical procedure or after the removal of dead skin and tissue.

Wound care supplies are not covered when needed for less serious conditions, such as burns, stage 1 pressure ulcers and wounds caused by trauma but don’t need to be surgically closed, like a skin tear.

Wound Care Supplies Not Covered by Medicare
  • Gauze used to clean a wound, later removed
  • Skin sealant
  • Small adhesive bandages
  • Surgical stockings
  • Topical antibiotics
  • Wound cleansers

More wound care supply options could be available through a Medicare Advantage plan, which private insurance companies provide. These plans include everything covered within Original Medicare and additional benefits.

Check with your provider to learn if additional wound care supplies or expanded coverage could be available through a Medicare Advantage plan.

Medicare Wound Care Documentation Requirements

There are Medicare documentation requirements that need to be met to cover wound care and supplies.

These documents detail your signs and symptoms to justify wound care as medically necessary, and demonstrate that treatment can positively impact the wound and its healing.

In the documentation, the status of your wound – such as its response to any treatment or supplies – is recorded. Other information about the injury, like its location, size and depth, should also be notated.

Your doctor may need additional information, such as a treatment plan, to document for Medicare to pay for care and supplies.

Last Modified: September 16, 2022

8 Cited Research Articles

  1. U.S. National Library of Medicine. (2022, April 17). Wound care centers. Retrieved from https://medlineplus.gov/ency/patientinstructions/000739.htm
  2. U.S. Centers for Medicare & Medicaid Services. (February 2021). Provider Compliance Tips for Surgical Dressings. Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ProviderComplianceTipsforSurgicalDressings-ICN909475Print-Friendly.pdf
  3. U.S. Centers for Medicare & Medicaid Services. (2021, January 28). Proposed Local Coverage Determination (LCD): Wound Care. Retrieved from https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=38901&ContrId=364
  4. U.S. National Library of Medicine. (2015, March). Chronic wound repair and healing in older adults: current status and feature research. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25753048/
  5. U.S. National Library of Medicine. (2014, August 1). Medicare Payment: Surgical Dressings and Topical Wound Care Products. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121050/
  6. U.S. Centers for Medicare & Medicaid Services. (n.d.). Local Coverage Article: Surgical Dressings – Policy Article. Retrieved from https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54563&ver=38&bc=CAAAAAAAAAAA
  7. U.S. Centers for Medicare & Medicaid Services. (n.d.). Local Coverage Determination (LCD): Wound Care. Retrieved from https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=37166&ver=22&Date=&DocID=L37166&bc=hAAAAAgAAAAA&
  8. U.S. Centers for Medicare & Medicaid Services. (n.d.). Surgical dressing services. Retrieved from https://www.medicare.gov/coverage/surgical-dressing-services