MM12290

Medicare covers Ventricular Assist Devices (VADs) for patients with NYHA Class IV heart failure and a left ventricular ejection fraction (LVEF) of 25% or less, contingent on specific clinical criteria such as being inotrope dependent or having a Cardiac Index (CI) < 2.2 L/min/m². Facilities must have qualified cardiothoracic surgeons and cardiologists experienced in VAD management, with an explicitly defined multidisciplinary team overseeing patient care. Documentation is required to demonstrate adherence to optimal medical management and clinical necessity for mechanical support, along with the qualifications of the VAD program coordinator.

"CMS covers Ventricular Assist Devices (VADs) under certain criteria effective December 1, 2020."

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