Home Cardiorespiratory Monitoring

Home cardiorespiratory monitoring devices to detect apnea, bradycardia, and other respiratory compromise are covered for at‑risk patients — notably high‑risk premature infants (covered up to 3 months after discharge or until 14 consecutive days without serious episodes), infants <12 months, those with tracheostomies or anatomic airway risks, neurologic/metabolic disorders affecting respiratory control, and chronic lung disease. Coverage is subject to the member’s benefit plan and state rules, is limited to FDA‑approved monitors with event recorders when possible, and excludes use for SIDS prevention, lower‑risk or recurrent/cluster BRUEs or prolonged events, uncomplicated obstructive sleep apnea (unless validated oximetry is added), and cases that do not meet age/prematurity criteria (e.g., >60 days and specified gestational/postconceptional ages).

"Medically necessary for premature infants at high risk of recurrent apnea, bradycardia, and hypoxemia for up to 3 months after hospital discharge or until 14 consecutive days without serious episod..."