Medicare to implement new policy on Coverage of Respiratory Assist Devices

On Dec. 1, 2014 the four DME Medicare Administrative Contractors (MACs) will implement a revised local coverage determination (LCD) for Respiratory Assist Devices (RADs). The policies describe coverage criteria for RADs (E0470 and E0471) for patients with conditions including central sleep apnea and complex (treatment emergent) sleep apnea. Revisions to the policy include definitions of central sleep apnea and complex sleep apnea that are more consistent with diagnostic criteria in the ICSD-3. 

To view your LCD, please visit the website of your DME MAC.  The LCDs are currently listed as “Future LCDs” in the policy section of each MACs website.  

Jurisdiction States MAC/Websites
Jurisdiction A CT, DC, DE, MA, MD, ME, NH, NJ, NY, PA, RI, VT NHIC
Jurisdiction B IL, IN, KY, MI, MN, OH, WI NGS
Jurisdiction C AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, VI, VA, and WV CGS
Jurisdiction D AK, AS, AZ, CA, GU, HI, ID, IA, KS, MO, MP, MT, NE, NV, ND, OR, SD, UT, WA, and WY Noridian
2014-11-20T00:00:00+00:00 November 20th, 2014|Clinical Resources, Professional Development|