CardioMEMS HF System coverage update
Last modified: Feb. 8, 2023
Revised an incorrectly referenced phone number for Provider Services.
Changes to coverage related to cardiovascular codes
Effective April 1, 2023, we will require prior authorization for CardioMEMS™ HF System (CPT® codes 33289 and C2624). The CardioMEMS HF System is unproven and not medically necessary due to insufficient evidence of safety and/or efficacy.
Impacted plans
These changes affect UnitedHealthcare commercial plans, UnitedHealthcare® Medicare Advantage, UnitedHealthcare Community Plans and Individual Exchange plans, also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans.
Omnibus policy
As of April 1, 2023, we’ll add the CPT codes (33289, 93264 and C2624) related to the CardioMEMS HF System to the Omnibus policy, which outlines CPT codes for services that are unproven, show a track record of limited effectiveness or are not a medical necessity.
Questions?
Contact Provider Services at 877-842-3210 for more information.
