US · guidance
CMS Pub. 100-04, ch. 32, § 260.1
Policy
The Centers for Medicare & Medicaid Services (CMS) received a request for national
coverage of treatments for facial lipodystrophy syndrome (LDS) for human
immunodeficiency virus (HIV)-infected Medicare beneficiaries. Facial LDS is often
characterized by a loss of fat that results in a facial abnormality such as severely sunken
cheeks. This fat loss can arise as a complication of HIV and/or highly active antiretroviral
therapy. Due to their appearance and stigma of the condition, patients with facial LDS may
become depressed, socially isolated, and in some cases may stop their HIV treatments in an
attempt to halt or reverse this complication.
Effective for claims with dates of service on and after March 23, 2010, dermal injections for
facial LDS are only reasonable and necessary using dermal fillers approved by the Food and
Drug Administration for this purpose, and then only in HIV-infected beneficiaries who
manifest depression secondary to the physical stigmata of HIV treatment.
See Pub. 100-03, National Coverage Decision manual, section 250.5, for detailed policy
information concerning treatment of LDS.
History
(Rev. 2105, Issued: 11-24-10, Effective: 03-23-10, Implementation: 07-06-10)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
cd8d7ec6ce5cf7bae23f8b6fc12fe00b52be19a7251ea22f3595661116159d84
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