CG-MED-86 Enhanced External Counterpulsation in the Outpatient Setting

This policy addresses outpatient enhanced external counterpulsation (EECP). A single course is medically necessary for individuals with disabling, chronic, stable angina (CCS Class III–IV or equivalent) who are refractory to optimal medical therapy and are not suitable candidates for revascularization (e.g., inoperable, high surgical risk, or unfavorable coronary anatomy), and who have no contraindicating comorbidities. EECP is not covered when these criteria are not met or for any other indications; key exclusions include conditions such as significant aortic insufficiency or clinically significant arrhythmias.

"A single* course of enhanced external counterpulsation (EECP) is consideredmedically necessaryfor individuals when the criteria below are met:Disabling, chronic, stable angina, (defined as Class II..."

Sign up to see full coverage criteria, indications, and limitations.