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The process of selling, delivering, training, billing, and collecting reimbursements for the Encore ED Vacuum Therapy products, follow a similar process as with most DME products. Below, we take you through each of the steps along with estimates for billing and reimbursements.

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Who Qualifies?

The following indication must be met:

● Impotence

In order for a patient to qualify under Medicare guidelines for the Encore ED Vacuum Therapy, an Rx is required from the Doctor indicating that there is a Medical Necessity for the patient to receive this product. The diagnosis include:

Diagnosis	Description
607.84	Organic Impotence

Items qualified for

If a patient is qualified, they may receive the following items:

Any of the 3 Encore Revive Devices - Deluxe Combo, Battery, or Manual
1 unit every 5 years

Doctors - Prescription (Rx)

Upon patient qualification and before placing an order, it is necessary to receive the approval from the patient's primary Doctor. The Prescription Rx form is sent or faxed to the Dr. for their signature.

Patient's authorization to bill Medicare

The standard patient authorization form needs to be signed by the patient and returned prior to billing Medicare.

Billing Medicare & Supplemental Insurance

Upon completion and certification that the Encore ED Vacuum Therapy Device has been delivered and accepted by the patient, the Medicare Provider company then bills Medicare, Supplemental Insurance, and possibly the patient for the co-pay amount.

Below is a schedule that shows the approximate Medicare billing amounts and reimbursements:

The Medicare allowable for the Encore ED Vacuum Therapy varies by State with the ranges given below.

Encore Vacuum Therapy Devices
Reimbursement Analysis


		Medicare	Medicare	Average	Average	Average
		Allowable	Average	Medicare	Dealer	Medicare
Description	HCPCS	Range	Allowable	Reimb.	Cost *	Margin

Deluxe Combo	L7900	$435 - $580	$490	$392	$130	$262

Battery	L7900	$435 - $580	$490	$392	$85	$307

Manual	L7900	$435 - $580	$490	$392	$75	$317

* Average Dealer Cost includes shipping.

Certification & Training

Encore Revive ED Vacuum Therapy - Medicare does not require any education or certification to provide these products. The DME is required to obtain accreditation for the HCPCS code L7900 in order to bill Medicare.

Innovate will be happy to provide phone consultation on: the products, patient qualifications, marketing, documentation, and the order process.

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