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Políticas Médicas

Las políticas médicas son documentos que definen el reconocimiento de cubierta para tecnologías, procedimientos y tratamientos. Las declaraciones de necesidad médica en las políticas, sobre si una tecnología, procedimiento, tratamiento, suplido, equipo, medicamento u otro servicio mejora el resultado en la salud de la población para la cual dicha tecnología o tratamiento fue diseñado se basan en evidencia científica, estudios clínicos y opiniones profesionales de nuestros proveedores y de las organizaciones médicas reconocidas.

Cada documento desplegado en este sitio Web se provee con propósitos informativos solamente y no es una autorización, explicación de beneficios o un contrato. El recibir beneficios está sujeto a la satisfacción de todos los términos y condiciones de la cubierta. La tecnología médica cambia constantemente y nos reservamos el derecho de revisar y actualizar nuestras políticas periódicamente.

ID Título Última Revisión Siguiente Revisión Descripción Acceso
08.001.057 Baroreflex Stimulation Devices Jun 19, 2023 Jun 20, 2024 Use of baroreflex stimulation implanted devices is considered investigational in all situations, including... Ver
08.001.059 Focal Treatments for Prostate Cancer Oct 19, 2023 Oct 20, 2024 Use of any focal therapy modality to treat individuals with localized prostate cancer... Ver
08.001.060 Dry Hydrotherapy for Chronic Pain Conditions Dec 14, 2023 Dec 20, 2024 The use of dry hydrotherapy massagers for the treatment of chronic pain conditions is... Ver
08.001.061 Stationary Ultrasonic Diathermy Devices Feb 12, 2024 Feb 20, 2025 Ultrasonic diathermy devices for the treatment of musculoskeletal pain are considered... Ver
08.002.001 Lipid Apheresis Jul 29, 2021 Policy Archived Low-density lipoprotein (ldl) apheresis may be considered medically necessary in patients with homozygous... Ver
08.003.001 Treatment of Tinnitus Mar 19, 2024 Mar 20, 2025 Psychological coping therapy including cognitive-behavioral therapy, self-help cognitive-behavioral therapy,... Ver
08.003.002 Outpatient Pulmonary Rehabilitation Apr 08, 2024 Apr 20, 2025 A single course of pulmonary rehabilitation in the outpatient ambulatory care setting may be... Ver
08.003.003 Cognitive Rehabilitation Nov 09, 2022 Policy Archived Cognitive rehabilitation (as a distinct and definable component of the rehabilitation process) may be... Ver
08.003.004 Sensory Integration Therapy and Auditory Therapy Apr 15, 2024 Oct 20, 2024 Sensory integration therapy and auditory integration therapy are considered investigational except for the... Ver
08.003.005 Endobronchial Brachytherapy Aug 15, 2023 Aug 20, 2024 Endobronchial brachytherapy may be considered medically necessary in the following clinical situations:... Ver
08.003.006 Cardiac Rehabilitation in the Outpatient Setting Apr 09, 2024 Apr 20, 2025 Outpatient cardiac rehabilitation programs may be considered medically necessary for individuals with a... Ver
08.003.012 Hippotherapy Apr 17, 2024 Apr 20, 2025 Hippotherapy is considered investigational.... Ver
08.003.013 Functional Neuromuscular Electrical Stimulation  Apr 08, 2024 Apr 20, 2025 Neuromuscular stimulation is considered investigational as a technique to restore function following nerve... Ver
09.001.001 CONSULTAS Aug 22, 2017 Policy Archived El médico consultor puede iniciar servicios diagnósticos y/o terapéuticos. la necesidad de consulta por... Ver
09.001.002 Hospice Services at Home Nov 11, 2020 Policy Archived Hospice services are considered for payment if they meet the following criteria: 1. physician... Ver
09.001.004  Endothelial Keratoplasty Apr 17, 2024 Apr 20, 2025 Endothelial keratoplasty (descemet stripping endothelial keratoplasty, descemet stripping automated... Ver
09.003.001 Corneal Topography/Computer-Assisted Corneal Topography/ Photokeratoscopy Apr 12, 2024 Apr 20, 2025 Non-computer-assisted corneal topography is considered part of the evaluation and management services of... Ver
09.003.002 Retinal Prosthesis Apr 17, 2024 Apr 20, 2025 Retinal prostheses are considered... Ver
09.003.003 FOTOCOAGULACIÓN DEL DRUSEN MACULAR Sep 21, 2016 Policy Archived Terapia con láser para la destrucción de drusen macular no se considera para pago, ya que no hay evidencia... Ver
09.003.004 Intraocular Radiotherapy for Age-Related Macular Degeneration Apr 12, 2024 Apr 20, 2025 Intraocular placement of a radiation source (brachytherapy) for the treatment of choroidal neovascularization... Ver
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