The VA can cover your cold and compression machine
Your surgeon wants cold and compression on the joint after surgery, and nobody walked you through the VA side of it. When a VA provider prescribes the NICE1, they document it in your chart and enter a consult. Once the VA authorizes the rental, there is no cost to you. The rest runs inside the VA system without you chasing it. You just have to get your provider to prescribe it, and this page covers that conversation.
Surgery is scheduled, cold and compression is in the plan, and nobody told you who pays for the machine
Plenty of veterans land here after asking someone at their facility and getting a no, or after a call that ended in a voicemail. That happens often enough that we built a VA-specific program around it.
VA facilities do authorize the rental of cold and compression devices after surgery. NICE Recovery Systems holds a Federal Supply Schedule contract, which lets a facility approve the rental without running a bidding process. Most veterans who go without one never got the request in front of the person who can enter it.
The rest of this page is instructions. It covers who to talk to, what to say, how to tell which VA path you are on, and what happens after the consult. A denial has its own section further down.
Nothing moves until a provider prescribes the NICE1 and enters the consult
Everything the VA does with equipment runs off the chart. Your provider prescribes the device, documents why you need it, and enters a consult in the VA system. The VA says consult for what your surgeon may call an order or a prescription.
Until that consult exists, nobody has anything to act on. So the whole thing turns on one short conversation with your provider. Ask clearly and most of what follows is waiting.
Your part
Handled inside the VA
You do this once
Ask your provider to prescribe the NICE1
Documented in your chart notes, with the consult entered. One conversation at one appointment.
Then this runs on its own
You are not pushing anything along
Ask your provider for this
"I'd like to use a NICE1 for my post-op recovery. Can you prescribe it, note it in my chart, and enter the consult?"
Write it down or screenshot it and take it to your appointment. Most veterans forget to mention the chart notes, which is what makes the consult findable later.
Two routes get a NICE1 to your door, and the difference is where your surgery happens
Both routes end with a NICE1 at your house and only differ at the front. Inside the VA, a provider enters the consult directly. With an outside surgeon, a review step runs first.
Path one
Direct VA
Your surgery and your follow-up care both happen inside the VA system.
Path two
Community Care
You are VA eligible, and your surgery is with a provider outside the VA.
A purchase order from O&P authorizes your rental. The VA uses that document to approve and pay for the equipment, and nobody is buying you a unit.
Community Care exists because VA surgical timelines run long in a lot of places, so veterans get sent out to have the procedure done sooner. That extra review step at the front is normal and does not mean anything is wrong with your request.
If your surgeon is not the right door, there are other people who can open it
Start with the surgeon, since the request carries more weight from the person doing the procedure. If that goes nowhere, work down this list. Provider here means whoever you are actually seeing, which could be a physician, a physician assistant, or a nurse practitioner.
Have this ready when you call us
You do not need all of it to make the first call. It is what we end up asking for, so gathering it early saves a round trip.
When the VA authorizes the rental, the machine comes to you at no cost
There is no copay and no deductible on this. Your VA facility authorizes the rental and covers it, so nothing gets billed to you. Two things have to happen first. A provider prescribes it, and the VA authorizes it.
A VA facility can move quickly because of the Federal Supply Schedule. NICE Recovery Systems holds an FSS contract, so pricing and terms are already negotiated with the government before your consult ever shows up.
Watch the calendar. Allow at least 14 days before your surgery date so the consult has room to move and the unit is at your house when you get home. Later can still work, and it gets tighter.
Your cost when the VA authorizes it
$0
No copay and no deductible once a provider prescribes it and the VA authorizes the rental. Your facility approves it under the Federal Supply Schedule.
Start this far ahead
14 days
Start at least two weeks before your surgery date so the machine is waiting at your house when you get home from the hospital.
Once the consult exists, most of the work moves over to us
Five things belong to us the moment your provider enters that consult.
We tell you who to talk to and exactly what to ask for. One call and you will know which provider at your facility to approach and how to word the request.
We help you identify which path applies. Direct VA or Community Care, and what the Community Care process is going to require from your outside provider.
We receive the purchase order from O&P. That document authorizes your rental. After O&P issues it, the paperwork runs between the VA and us.
We deliver to your home and set you up. The wrap gets fitted, you get shown how to run the machine, and we support you through the rental.
We offer the same rental as self-pay if the VA denies it. Identical machine, identical terms, and you can start while the VA side gets sorted out.
Four things sit outside what we can touch.
We cannot enter the consult. Only a VA provider can put it in the system.
The Community Care request is not ours to file. Your outside provider fills that out.
We cannot advocate on your behalf inside the VA. You can speak up for yourself, and your facility has a patient advocate who can help.
The approval decision belongs to your facility. Some deny over cost or an existing vendor relationship, and no call from us changes that.
Some facilities deny the request, and you still have a way to get the machine
Denials usually come down to one of these, none of which is about you or your surgery.
Starting point
Your VA facility denied the request
Route one
Speak up inside the VA
Go back to your provider about the documentation, and ask the patient advocate at your facility to look at the denial with you.
You and your facility
Route two
Start a self-pay rental
The same machine on the same rental program, arranged directly with us. No VA authorization needed.
Available now
These are not either or. You can start a rental while you work the denial with your facility.
The VA does not run a formal appeal for equipment the way an insurance carrier does. You speak up for yourself, and your facility has a patient advocate whose job is working problems like this for veterans. Ask your provider whether the documentation can be strengthened, then take it to the advocate if it stalls.
Self-pay is the honest fallback and plenty of veterans use it. Call and we will tell you what it runs for the length your surgeon has in mind, or start the request at the bottom of this page.
Worth knowing
Starting a self-pay rental does not close the VA door. Some veterans start self-pay to cover the first weeks after surgery while their provider works the consult through.
What you are actually getting, and why it beats a cooler full of ice
Cold and compression stops working for most people because they stop doing it, usually around day four, when the ice runs feel like more trouble than the swelling is worth. The NICE1 keeps going past the point where a cooler gets abandoned.
There is a wrap for the joint you had worked on, including an amputee wrap.
Knee, ankle, hip, shoulder, hand, elbow, lumbar, cervical, and wrist. The amputee wrap is worth calling out on its own, since residual limb swelling drives fit, pain, and how soon a prosthesis works right. Tell us what was done when you call and we will send the right wrap.
The VA process is identical no matter which wrap you need, so nothing above changes.
What veterans ask us before the consult goes in
How do I know if I am Direct VA or Community Care? +
Look at where your surgery is happening. A VA medical center means Direct VA. An outside hospital or surgical center arranged through the VA, usually because of wait times or distance, means Community Care. Your VA care coordinator can confirm it in a minute, and so can we when you call.
What if my surgery is at a community hospital? +
You are on the Community Care path, and it still works. Your outside provider files the request, the VA reviews it, and a VA provider enters the consult. People miss that the outside provider has to prescribe and document it first. Ask at your pre-op appointment.
Who at the VA do I talk to if my surgeon will not do it? +
Your VA primary care provider can prescribe it. A VA liaison or care coordinator is the fastest way to find the right provider even though they cannot enter the consult themselves. They know how their facility handles equipment requests. Call us first if you want the wording to bring to that appointment.
How long does the consult take to come through? +
It varies by facility and by how busy O&P is that week. Plan on at least 14 days between the consult and your surgery date. Community Care adds a review step in front, so give that path more room. Delivery is quick once the authorization reaches us.
What does the VA actually cover? +
The rental of the machine and the wrap for your joint, delivered to your home. Your facility authorizes the rental under the Federal Supply Schedule, so there is no copay or deductible on your end. Coverage decisions belong to your VA, so confirm the specifics with your provider and your facility.
Can I get one if my surgery already happened? +
Yes, and it is worth asking. The consult can be entered after surgery as long as your provider documents why you still need it. Swelling sticks around for weeks in most joints, so there is usually a case to make. If you are already home and hurting, self-pay bridges the gap.
What happens if my VA has a different vendor? +
Then your facility may route the request to that vendor instead, and that is their call. Your provider can name NICE in the consult and explain why in the chart notes, which sometimes changes the outcome. If the facility holds firm, self-pay is there and you are not stuck waiting.
Can my spouse or caregiver call on my behalf? +
Absolutely, and most of these calls come from a spouse. Anyone helping you can call us and get the whole process explained. The VA has its own rules about who it will talk to and what release forms it needs, so ask your care coordinator about that part.
Call before your appointment and walk in knowing exactly what to ask for
You do not need the consult in hand to call us. Your surgery date, which VA, and the provider's name is enough to start, and we can usually sort out your path on that call.
Do you work at a VA facility? Procurement details, contract numbers, and ordering information are on the FSS provider page.
Coverage decisions belong to your VA facility and can vary. Nothing here is legal, insurance, or medical advice. Follow the protocol your clinician gives you.