Q: I was wondering how long the pessaries are supposed to last? I have a patient who is using a cube pessary, but the device has cracked and is tearing around the attachment of the string. It has been in use for less than a year (since February of 2025).
A: While medical-grade silicone pessaries can have a shelf life of up to 10 years, their actual useful life varies from patient to patient. Factors like how often the pessary is removed, how it’s cleaned, and the patient’s individual anatomy all play a role. In general, most silicone pessaries last anywhere from 1–5 years, and many clinicians choose to replace them every 1–3 years as a precaution.
Any time a pessary shows signs of tearing, cracking, stiffness, discoloration, or odor, it should be replaced right away. In this case, since the damage is around the string, I don’t want to make assumptions, but we often see this happen when patients use the string to pull the pessary out. The string is meant only to help locate the device, not to remove it, and repeated pulling combined with normal cleaning and vaginal acidity can start to weaken the silicone string area over time.
Q: Can physical therapists bill for pessary fittings and the pessary itself?
A: Physical therapists are not authorized to use the same billing codes as physicians and cannot bill insurance for the pessary devices themselves.
Q: How can physical therapists receive reimbursement if they cannot bill the same as physicians?
A: Physical therapists can charge cash for both the pessary fitting and the device itself. Alternatively, they may bill the fitting using orthotic management codes and charge cash specifically for the pessary.
- 97761: Initial encounter, fitting/training, each 15 minutes
- 97763: Orthotic management/training, each 15 minutes