Payer PolicyActive
DME.00037 Cooling Devices and Combined Cooling/Heating Devices
ANTHEM-DME.00037
Anthem
Effective: July 1, 2025
Updated: December 30, 2025
Policy Summary
- Policy addresses active and passive cold therapy devices (with or without pneumatic compression or vibration) and devices that combine cooling and heating. - Coverage: These devices are considered investigational/experimental and not medically necessary for all indications, including post–orthopedic surgery or trauma; therefore, they are not covered. - Key limitations: No covered indications or exceptions; relevant codes include E0217, E0218, E0236, E0675, E0676, and E1399.
Coverage Criteria Preview
Key requirements from the full policy
"Active or passive cooling devices (with or without pneumatic compression or vibration) are consideredinvestigational andnot medically necessaryfor all uses, including but not limited to recovery af..."
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