Iontophoresis Insurance Help
Since iontophoresis is recognized as medical therapy for the treatment and control of hyperhidrosis, some health insurance companies may cover a portion of the costs.
Patients typically purchase an iontophoresis device and then obtain a reimbursement directly from the insurance company. It is recommended that patients and/or medical providers contact the insurance carrier prior to device purchase to obtain pre-authorization.
Links to some major policies are provided here as well as information about the support iontophoresis device companies can provide:
- Aetna’s Insurance Policy on Iontophoresis for Hyperhidrosis
- Cigna’s Insurance Policy on Iontophoresis for Hyperhidrosis
- R.A. Fischer Company: Medical Insurance Claim Statement Form to be completed and submitted to the appropriate health insurance organization by the treating physician along with a copy of the prescription and purchase receipt so that patients may get reimbursed for the purchase. R.A Fischer also offers a flexible monthly payment program allowing patients to purchase a device over seven months (available only to U.S. residents) and an online form so that R.A. Fischer staff can look into health insurance carrier’s hyperhidrosis/iontophoresis coverage policies on behalf of the patient. They also assist in obtaining a pre-authorization from your insurer.
- Hidrex USA: provides an Insurance Reimbursement Assistance Guide.
- Dermadry: provides its Insurance Reimbursement Guide.
- Patients can also look on our Fan Fave page to see if there are any iontophoresis devices that are offering special discounts. Periodically, they do.
Treating clinicians may need the codes below when assisting patients with insurance coverage:
Iontophoresis Procedure Codes:
97033 - Iontophoresis, each 15 minutes, physicians typically bill for 2-4 units depending on how many areas are treated.
99211- Pertains to an evaluation and management (E/M) service. Defined as an office or other outpatient visit “that may not require the presence of a physician.” Usually, the presenting problem(s) are minimal. Typically, five minutes are spent performing or supervising these services.
99213 - Can be utilized for a mid-level outpatient or inpatient office visit. It is a level three code that should be used for an established patient.
Use -25 modifier for significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service.
For reimbursement purposes use the more specific codes when possible:
L74.512 – Primary focal hyperhidrosis, palms
L74.513 – Primary focal hyperhidrosis, soles
L54.510 - Primary focal hyperhidrosis, axilla
L74.5 - Focal hyperhidrosis
L74.51 - Primary focal hyperhidrosis
L74.52 Secondary focal hyperhidrosis
L74.8 Other eccrine sweat disorders
L74.9 Eccrine sweat disorder, unspecified
Keep in mind that iontophoresis is a learned technique. Ideally, patients perform the technique at home using their own iontophoresis device after detailed training and practice under your (or your staff's) supervision. Patients can find tips on making the most of iontophoresis here.