Transcatheter and Device-Based Hemodynamic Management Procedures - Medicare Advantage

This policy covers transcatheter and device‑based hemodynamic management procedures including baroreflex activation therapy (Barostim Neo), implantable pulmonary artery pressure sensors (e.g., CardioMEMS, Cordella), investigational left atrial and IVC hemodynamic sensors, and catheter renal denervation for management and monitoring of heart failure and resistant/uncontrolled hypertension. Key populations include symptomatic HFrEF patients (NYHA II–III, LVEF ≤35%, NT‑proBNP >1600 pg/mL) and patients with hypertension uncontrolled despite medications/lifestyle; major limitations require use of FDA‑approved systems (Barostim Neo approved for HF; Barostim Legacy HDE limited to obsolete Rheos‑lead responders), LAP/IVC devices are investigational, renal denervation is adjunctive after failed medical therapy, and CRT‑eligible patients are excluded from Barostim implantation.

"Implantable carotid sinus baroreflex activation system (Barostim Neo) purported to treat resistant hypertension (RHT)."