Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting

This policy covers cardiac hemodynamic monitoring in the outpatient/ambulatory setting using stand‑alone ambulatory devices (including certain FDA‑approved ambulatory or implantable pressure sensors) to guide fluid management and detect physiologic changes that precede heart failure decompensation. It applies to patients with chronic heart failure at risk of or with prior decompensation, those on continuous inotropes, and select transplant or pacemaker optimization indications, but is limited to ambulatory use, excludes integrated implantable cardiac devices, and designates several techniques (e.g., inert gas rebreathing, arterial Valsalva, implantable pulmonary artery/left atrial pressure monitoring) as experimental/investigational or only covered within defined FDA‑approved indications.

"Differentiation of cardiogenic versus pulmonary causes of acute dyspnea when history, exam, and standard assessments are insufficient."