Is there any way that we can get Medicare to cover more then 15 visits for a life time?

The Medicare rules have changed with respect to limitations on therapy. In a nutshell, Medicare can no longer limit therapy if there is no expectation of an improvement. You can still obtain therapy if your physician states that there is a medical necessity for skilled therapy services, and the therapy is necessary to maintain your current condition by preventing deterioration. Below are abstracts from the revised Local Coverage Determination L26884 for Outpatient Therapy. Quote this to anyone telling you that there is a limit.

Bear in mind, however, that any therapy whose billed value is more than $3900/year will be audited, and the physician must make a strong case for your need for such therapy.

Medicare coverage does not turn on the presence or absence of a beneficiary's potential for improvement from the therapy, but rather on the beneficiary's need for skilled care.

Maintenance Therapy
Skilled therapy services that do not meet the criteria for rehabilitative therapy may be covered in certain circumstances as maintenance therapy under a maintenance program. The goals of a maintenance program would be, for example, to maintain functional status or to prevent or slow further deterioration in function. Establishment or design of maintenance programs. If the specialized skill, knowledge and judgment of a qualified therapist are required to establish or design a maintenance program to maintain the patient's current condition or to prevent or slow further deterioration, the establishment or design of a maintenance program by a qualified therapist is covered. If skilled therapy services by a qualified therapist are needed to instruct the patient or appropriate caregiver regarding the maintenance program, such instruction is covered. If skilled therapy services are needed for periodic reevaluations or reassessments of the maintenance program, such periodic reevaluations or reassessments are covered.

Maintenance Programs
Skilled therapy services are covered when an individualized assessment of the patient's clinical condition demonstrates that the specialized judgment, knowledge, and skills of a qualified therapist are necessary for the performance of safe and effective services in a maintenance program. Such skilled care is necessary for the performance of a safe and effective maintenance program only when (a) the therapy procedures required to maintain the patient's current function or to prevent or slow further deterioration are of such complexity and sophistication that the skills of a qualified therapist are required to furnish the therapy procedure or (b) the particular patient's special medical complications require the skills of a qualified therapist to furnish a therapy service required to maintain the patient's current function or to prevent or slow further deterioration, even if the skills of a therapist are not ordinarily needed to perform such therapy procedures.

See my other posting for further information, and go onto my web site for articles on the improvement standard, Jimmo VS Sebelius, and LCDs.

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Lymphedema Treatment is Good Business as well as Good Medicine
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