Home Ventilators - (0546)

Cigna covers rental in‑home ventilators (HCPCS E0466–E0468)—including multifunction (E0467) and dual‑function (E0468) units when the extra functions are specifically required—but excludes use as respiratory assistance devices (CPAP/APAP/BPAP/ASV/AVAPS/iVAPS), treatment of OSA, non‑life‑threatening indications, duplicate/back‑up units, and invasive interfaces. Coverage requires documentation of one of the listed life‑threatening conditions, prior BPAP failure to correct hypercapnia/oxygenation, that the patient does not require continuous (24‑hour) ventilation for noninvasive interfaces, compliant use and pretreatment criteria for continued use, device‑specific function needs for E0467/E0468, and ongoing rental period authorizations.

"Ventilators are rental only DME and require on-going rental period authorizations."

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