Medicare Policy for Chelation Therapy
Stephen Barrett, M.D.
Medicare does not cover the administration of chelation therapy for the treatment of cardiovascular diseases or any other disease or condition commonly treated by doctors who use it for the treatment of cardiovascular disease. Here is the pertinent section from the Centers for Medicare and Medicaid Medicare Coverage Database. ("NCD" is an abbreviation for National Coverage Determination.) Because chelation has legitimate use for treating heavy metal poisoning, some chelation therapists submit insurance reports claiming to have treated lead poisoning or another alleged toxic state. Any such submission would constitute a serious federal crime.
NCD for Chelation Therapy for Treatment of Atherosclerosis (20.21)
Manual Section Number
Effective Date of this Version
This is a longstanding national coverage determination. The effective date of this version has not been posted.
Incident to a physician's professional service
Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.
Chelation therapy is the application of chelation techniques for the therapeutic or preventive effects of removing unwanted metal ions from the body.
Indications and Limitations of Coverage
The application of chelation therapy using ethylenediamine-tetra-acetic acid (EDTA) for the treatment and prevention of atherosclerosis is controversial. There is no widely accepted rationale to explain the beneficial effects attributed to this therapy. Its safety is questioned and its clinical effectiveness has never been established by well designed, controlled clinical trials. It is not widely accepted and practiced by American physicians. EDTA chelation therapy for atherosclerosis is considered experimental. For these reasons, EDTA chelation therapy for the treatment or prevention of atherosclerosis is not covered.
Some practitioners refer to this therapy as chemoendarterectomy and may also show a diagnosis other than atherosclerosis, such as arteriosclerosis or calcinosis. Claims employing such variant terms should also be denied under this section.
This page was posted on August 23, 2004.