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US · guidance

CMS Pub. 100-04, ch. 32, § 260.1

Policy

activein force · 2026-08-25 – presentas-observed

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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