Currently Medicare's blanket restriction for transitional related surgeries (gcs, ba, and ffs) has been lifted. For traditional Medicare (not advantage) Medicare does not have a national policy of coverage, rather reviews each case on a case by case basis. The good part of this is Medicare uses wpath standards of care for approval/denial.
Check out
www.transmedicare.com for more details and their section on known surgeons that accept Medicare.
Also a few months ago legislation was passed so that no Medical provider could deny care based on gender identity.
This goes into effect January 2017
This is important as for a long time (since ban was lifted in 2014) Medicare had the reputation of approving coverage but reimbursement for gcs was less than an orchie.
The result of this was that surgeons who did perform gcs, and accepted Medicare simply refused services for Medicare patients wanting GRS.
What that legislation means is if they now refuse based on reimbursement rates they are at risk for losing their Medicare contract. This is Very good news for us, as the incentive for the surgeon's billing department to fight for market rate reimbursement is in their court, and not on the patients.
The current status for coverage is here
https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=282Sent from my iPhone using Tapatalk
