Does Medicare Cover Ostomy Supplies? Part B Rules, Catheters and Wound Care

General information about Original Medicare coverage rules, not medical advice and not a coverage determination for any person. Coverage depends on the individual’s eligibility and the clinician’s order.

Short answer

Yes. Original Medicare Part B covers medically necessary ostomy supplies under the prosthetic device benefit for people who have had a colostomy, ileostomy or urinary ostomy. After the Part B deductible, the person pays 20% of the Medicare-approved amount. Catheters and wound care supplies are not covered by the ostomy policy: they fall under two separate Medicare policies with their own criteria, covered below.

What Part B covers: the prosthetic device benefit

Medicare.gov states that Part B covers “medically necessary ostomy supplies under the prosthetic device benefit, if you’re eligible,” and that the quantity is “the amount of supplies your doctor or other health care provider says you need.” Eligibility turns on having had a colostomy, ileostomy or urinary ostomy. CMS describes the use as a surgically created opening (a stoma) that diverts urine or fecal contents outside the body, and states that ostomy supplies used for other conditions are denied as non-covered.

The coverage rules sit in Local Coverage Determination (LCD) L33828, Ostomy Supplies, with Policy Article A52487. Under the LCD, items must be reasonable and necessary, and a Standard Written Order (SWO) must exist before a claim is submitted; without one the claim is denied. The type of ostomy is what primarily decides how many supplies a person is expected to use, according to CMS. For the HCPCS codes behind these items, see DME HCPCS codes; for a general view of what the DME benefit does and does not reimburse, see Medicare DME coverage.

Quantity limits and the “not both” pairs

LCD L33828 lists usual maximums. Quantities above them are payable only when the medical record documents the reason; CMS’s compliance guidance says to “clearly document in the patient’s medical record the explanation for using a greater supply quantity,” and excess that is not documented is denied as not reasonable and necessary. Proof of delivery is also required.

HCPCS code	Usual maximum in the LCD
A4357	2 per month
A4369	2 per month
A5055	31 per month
A6216	60 per month
A5102	2 per 6 months
A5120	150 per 6 months

The same policy also pairs items that Medicare will not pay for together. These are a common source of denials:

Item type	What CMS says
Liquid barrier	Spray (A4369) or wipes (A5120), not both. See A5120 skin barrier wipes.
Urinary ostomy night drainage	A bag (A4357) or a bottle (A5102) at night, not both.
Continent stoma cap, plug, cover or gauze type items	No more than one of that type per day.

Does Medicare cover catheters?

Sometimes, but under a different policy. The ostomy LCD does not mention urinary catheters. Catheters are addressed in LCD L33803, Urological Supplies, which states that intermittent catheterization is covered when basic coverage criteria are met. A Standard Written Order is required, and a missing order means denial.

• Sterile intermittent catheter kits (A4297, A4353) are covered in specific situations only: a nursing facility resident, an immunosuppressed person, radiologically documented vesico-ureteral reflux while on intermittent catheterization, or distinct recurrent urinary tract infections (“twice within the 12-months prior to the initiation of sterile intermittent catheter kits”).
• Quantity: usual maximum of 200 per month for A4295, A4296, A4297, A4332, A4351, A4352 and A4353.
• External catheters are covered for permanent urinary incontinence, and male external catheters generally should not exceed 35 per month.

For one straight-tip catheter code, see A4351; for the incontinence side of the urological policy, see does Medicare cover incontinence supplies.

Does Medicare cover wound care supplies?

Only a defined set, under LCD L33831, Surgical Dressings. Coverage is limited to primary and secondary surgical dressings used on the skin on specified wound types; for some items (compression, zinc paste) the wound must be surgically created or modified, or debrided. A Standard Written Order is required.

• Coverage is by wound type: the policy lists which dressing categories are covered for which specified wound types, so a dressing is judged against the policy, not just the product name.
• Hydrogel: the LCD says it is not reasonable and necessary for stage 2 ulcers.
• Compression without a qualifying wound is denied as statutorily non-covered, no benefit. Silver, honey or copper materials are not considered reasonable and necessary.

Three policies, three checklists

Ostomy, urological and surgical dressing supplies are three separate LCDs. A supplier or clinic that applies one policy’s rules to another’s items is the usual cause of avoidable denials. The table maps each question to its policy.

Question	Policy	Key gate
Ostomy pouches, barriers, wipes	L33828 (Article A52487)	Stoma from a colostomy, ileostomy or urinary ostomy
Catheters	L33803	Basic coverage criteria; sterile kits only in listed situations
Wound dressings	L33831	Specified wound types listed in the LCD

Documentation checklist

These items come from the three LCDs and the CMS ostomy compliance guidance. All three policies require a Standard Written Order.

1. A Standard Written Order on file before the claim.
2. The correct HCPCS code for the item and the correct policy for that code.
3. Quantity at or under the usual maximum, or a medical-record explanation for a higher quantity.
4. Proof of delivery.
5. For refills of ostomy items, the supplier contacts the beneficiary or designee no sooner than 30 calendar days before supplies run out and gets an affirmative response before dispensing.
6. No paired items that the policy excludes together (for example A4369 and A5120).

Quantities in these tables are LCD “usual maximums” and LCDs are revised, so check the current LCD on the CMS Medicare Coverage Database before relying on a number. For the ostomy products themselves, see one-piece ostomy bags and ostomy adhesives.

Common misunderstandings

• “The ostomy benefit covers catheters.” The ostomy LCD does not mention them; catheters sit in the urological policy.
• “Any wound dressing is covered.” Surgical dressing coverage is limited to specified wound types listed in the LCD.
• “More supplies are always allowed if I need them.” Higher quantities are payable only when the record documents why.
• “Ostomy supplies are covered for any condition.” CMS denies them as non-covered when used for conditions other than a stoma.

FAQ

Does Medicare cover ostomy supplies?

Yes, Part B covers medically necessary ostomy supplies under the prosthetic device benefit for people with a colostomy, ileostomy or urinary ostomy, with 20% coinsurance of the Medicare-approved amount after the deductible.

Does Medicare cover catheters?

Intermittent catheterization is covered when basic coverage criteria are met under the urological supplies policy (L33803), with stricter criteria for sterile kits. The ostomy policy does not address catheters.

Does Medicare cover wound care supplies?

Surgical dressings are covered for specified wound types under L33831, with coverage tied to the wound types the LCD lists.

This page describes Original Medicare only.

Sources

• Medicare.gov, Ostomy supplies (checked 2026-11-01): medicare.gov/coverage/ostomy-supplies (checked 2026-11-01)
• CMS Medicare Learning Network, Ostomy supplies compliance tip: cms.gov MLN (checked 2026-11-01)
• CMS Medicare Coverage Database, LCD L33828 Ostomy Supplies: L33828 (checked 2026-11-01)
• CMS Medicare Coverage Database, LCD L33803 Urological Supplies: L33803 (checked 2026-11-01)
• CMS Medicare Coverage Database, LCD L33831 Surgical Dressings: L33831 (checked 2026-11-01)