Q: I have a prescription for a Lymphoedema Garment with additional items, do these additional items incur any more charges? How many patient charges are there in total?

A:  Prescriptions for lymphoedema garments can have several variations of patient levy, as explained below. We recommend having a copy of the tariff to hand.

This TariffTip applies to England, Wales, Scotland and Northern Ireland.

The first point to note is that, unlike elastic compression hosiery, there is only one patient charge for each type of garment, irrespective of the number of garments prescribed. For example 2 pairs of class II lymphoedema stockings attracts one patient charge, not four.

So, lymphoedema items of the same compression class and the same garment type (known as a base garment) always incur one patient charge, even if the quantity is for more than one.

Many lymphoedema garments have optional extras that support their use and can be prescribed alongside the garment. Additional items that can be prescribed are listed under the garment in the Drug Tariff.

The wording in the tariff states; ‘NB: The above garments are available with additional options. These are priced separately. See below’

Examples of additional options can include ‘lining inside elbow’, ‘pockets’, ‘zip’, ‘reinforced palm’.

There is no patient charge applicable to any additional option prescribed with a lymphoedema garment.

Example A
2 x Class III Jobskin Armsleeve and Gauntlet FP0502-2

2 x Lining Inside Elbow FP1167

1 x Zip Less Than 8’’ (20cm) FP1165 

This prescription attracts one patient charge and one professional fee as the same base garment of the same compression class has been prescribed along with optional extras.

However, if there were two different types of lymphoedema garment or base garments of a different compression class, then multiple charges will apply. Optional extras remain free of patient charges.

Example B
1 x Jobst Elvarex Custom Fit Class I T/High stocking L1-01-06

1 x Jobst Elvarex Custom Fit Class II T/High stocking L2-02-06

1 x Silicone Band U-A004  

This prescription attracts two patient charges and two professional fees; whilst the garment type is the same they are of different compression classes. The silicone band is an additional option.

The Drug Tariff wording is as follows:

'Where lymphoedema garments are prescribed including specifically prescribed additional options, the dispenser must ensure that full details including order codes are clearly endorsed on the FP10. The additional options for the base garments do not attract any additional prescription charges.'

'One prescription charge is payable where one or more of the same base garment is supplied. More than one prescription charge is payable if different base garments (Including different compression of the same garment type) are ordered.'
(See Part XVI sub-paragraph 12.13)

Tariff Tip written by Sue Swift, UK Drug Tariff and Information Technician