Clinical Policies
-
A
- Acoustic cardiography/heart sound recording
- Actigraphy
- Air ambulance transport
- Altered auditory feedback devices for speech dysfluency (stuttering)
- Ambulatory blood pressure monitoring
- Ambulatory continuous peripheral nerve block for chronic pain
- Apnea monitors for infants-in home use
- Aquatic therapy
- Art therapy
- Athletic pubalgia (sports hernia) surgery
- Auricular stimulation for abdominal pain from irritable bowel syndrome
-
B
- Balloon dilation of the Eustachian tube
- Behavioral health weight management interventions for children with increased body mass index screenings
- Biofeedback for chronic pain
- Bioimpedance devices for detecting lymphedema
- Blue Native polyacrylamide gel electrophoresis for mitochondrial myopathies
- Bone graft substitutes
- Bone marrow transplant for children with hyper IgM disorder
- Botulinum toxin for constipation
- Brachytherapy for cancers other than prostate
- Breast pumps
- Bronchial thermoplasty for severe asthma
-
C
- Cardiac contractility modulation
- Cecostomy for fecal incontinence
- Cervical cancer and human papillomavirus screening
- Cervical traction devices for neck pain for home use
- Chronic inflammatory response syndrome
- Computer-aided detection and diagnosis for chest imaging
- Computerized gait analysis
- Core decompression for avascular necrosis of the hip
- Corneal cross-linking
- Coronary intravascular lithotripsy
- Cryopreservation of reproductive tissue, gametes, and embryos
- Customized lymphedema garments
-
D
- Dermabrasion and chemical peel
- Digestive enzyme cartridge
- Disposable insulin delivery devices
- Donor human milk
- Drug-eluting sinus implants
- Dynamic movement orthoses (suit therapy)
- Dynamic splinting
-
E
- Electrical muscle stimulation
- Embrace 2 watch for seizure detection.
- EndeavorRx video for ADHD
- Endovenous stents
- Epidermal nerve fiber density testing
- Equine-assisted therapy
- Excimer laser for vitiligo
- External counterpulsation therapy
-
F
- Face transplantation
- Fetal surgeries in utero
- Fluorescence in situ hybridization for cervical cancer screening
- Fluorescence spectroscopy for prostate cancer diagnosis
- Fundus photography
-
G
-
H
- Hand and arm transplants
- Hidradenitis suppurativa surgery
- Home spirometry
- Home uterine activity monitoring
- Home-use light box therapy for seasonal affective disorder
- Hydrogel spacer use during radiotherapy for prostate cancer
- Hypoglossal nerve stimulation
-
I
- IFuse implant system
- Immune cell function assays in transplantation
- Inhaled nitric oxide
- Injectable bulking agents — fecal incontinence
- Intermittent pneumatic compression for peripheral artery disease
- Intracranial hypertension stent
- Intravascular ultrasound
-
K
-
L
- Laser interstitial thermal therapy for drug-resistant epilepsy
- Latera absorbable nasal implant
- Lipoprotein apheresis
- Lung transplants
-
M
- Manipulation under anesthesia (hip and elbow)
- MarginProbe®
- Measurement of serum antibodies to Infliximab and Adalimumab
- Medical alert devices
- Medical three-dimensional printing
- Melody™ transcatheter pulmonary valve replacement
- Microwave thermotherapy for breast cancer
- Microwave thermotherapy for lung and kidney tumors
-
N
-
O
-
P
- Pancreas transplantation
- Pediatric intensive feeding programs
- Pediatric rhinoplasty
- Pediatric turbinoplasty
- Percutaneous sacroplasty
- Peripheral nerve stimulators for chronic nerve pain
- Peristeen® anal irrigation system
- Peroral endoscopic myotomy
- Pet therapy
- Phototherapy and photochemotherapy for skin conditions
- Phrenic (diaphragmatic) nerve stimulation
- Plastic reconstructive surgery
- Platelet rich plasma for nonhealing diabetic wounds
- Postural orthostatic tachycardia syndrome treatment with physical therapy
- Prescription digital therapeuticss for contraception
- Prolotherapy
- Prostatic urethral lift/UroLift for benign prostatic hypertrophy
- Pulsed dye laser for port-wine stain and infantile hemangioma
-
R
- Radiofrequency ablation of genicular nerves for knee pain
- Re-SET-O
- Renal denervation
- Robotic orthoses – lower limb
- Robotic orthoses – upper limb
- Room humidifiers
-
S
- Sacral nerve modulation/stimulation
- Scoliosis vertebral body tethering and stapling
- Shoe lifts for leg length discrepancy
- Sialendoscopy and lithotripsy for salivary stones
- Skin surgery after massive weight loss
- Smell and taste dysfunction testing
- Specialized infant formula
- Speech therapy
- Sphenopalatine ganglion block injections for headache
- Stereotactic navigation in sinus surgery
- Supraglottoplasty and laryngoplasty
-
T
- Tactile breast imaging
- Therapeutic contact lenses
- Three-dimensional imaging and interpretation
- Topical oxygen therapy
- Total artificial heart
- Transanal radiofrequency for fecal incontinence
- Transcatheter coronary infusion of supersaturated oxygen therapy in acute myocardial infarction
-
V
- Vaginitis diagnostic testing
- Vagus nerve stimulation for post-stroke upper limb rehabilitation
- Vestibular evoked myogenic potential testing
- Video head impulse testing
- Virtual colonoscopy – CT colonography
- Vitamin D screening
- Volatile organic compounds for urinary tract infection
-
W
- Wearable dialysis and implantable artificial kidneys
- Wheelchair mounted robotic arm – Kinova Jaco2
- Wireless pulmonary artery pressure monitoring devices for heart failure
-
X