Third-Party Coverage
Third-Party Coverage Policies & Approvals Include:
- Medicare National Coverage Determinations Manual, CMS Pub. No. 100-03, Chapt. 1, Part 1, § 20.6 authorizes performance of TMR by properly trained staff at hospitals with dedicated cardiac care units for patients meeting specified characteristics.
- Blue Cross Blue Shield Association Technology Evaluation Center concludes that TMR “improves net health outcomes” and meets criteria for reimbursable therapy, January 1999.
- FDA approval granted for TMR performed with the Cardiogenesis TMR System, February 1999.
- Humana Coverage Policy authorizes reimbursement for TMR for PPO, HMO, Medicare & Medicaid HMOs, January 2000.
- Aetna US Healthcare Coverage Policy authorizes reimbursement for TMR for all plans, 2000.
- Cigna Coverage Policy authorizes reimbursement for TMR for all plans, 2000.
- Blue Cross Blue Shield Association Technology Evaluation Center concludes that TMR+CABG “improves net health outcomes” and meets criteria for reimbursable therapy, May 2001.
- Tricare Policy Manual Update, August 2002.