Implantable Wireless Pulmonary Artery Pressure Monitoring

This policy covers implantation and use of an FDA‑approved implantable wireless pulmonary artery pressure monitor (e.g., CardioMEMS) for remote hemodynamic monitoring to guide outpatient heart failure therapy and reduce HF hospitalizations, primarily for NYHA Class III patients with a heart‑failure hospitalization in the prior year (including HFrEF and HFpEF). Coverage is limited to FDA‑approved devices (currently CardioMEMS), is investigational/not covered for most non‑Medicare Centene plans, and Medicare coverage is restricted to members enrolled in the Medicare Category B IDE study (NCT03387813); anticoagulation is covered only for one month post‑implant and broader use is constrained by limited long‑term evidence.

"Implantation and use of an FDA‑approved implantable wireless pulmonary artery pressure monitor (e."

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