Cardiac Pacemakers - Medicare Advantage

This policy covers permanent cardiac pacemakers (single‑ and dual‑chamber and leadless devices), pacemaker evaluation and monitoring services, and related cardiac electrophysiology procedures for treatment of bradycardia such as sinus node dysfunction and atrioventricular (AV) block. Coverage is governed by applicable CMS NCDs/LCDs/LCAs and the Medicare Administrative Contractor's jurisdiction (Part A/B), and leadless single‑chamber devices are limited to right‑ventricular pacing and are not appropriate for dual‑chamber pacing, CRT, or ICD indications—consult the referenced LCD/NCD and billing/coding guidance for specific medical necessity criteria.

"Clinical technology is constantly evolving, and we reserve the right to review and update this policy periodically."

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