Medicare: Coverage criteria for pulmonary artery pressure sensors

The Centers for Medicaid and Medicare Services (CMS) covers FDA approved implantable pulmonary artery sensors (IPAPS) for heart failure management under coverage with evidence development (CED) for dates of service on and after Jan. 13, 2025.

How to avoid claim denials

The following steps are a few highlights of the coverage criteria. Please refer to the CMS instructions for complete details:

• The service must be part of a CMS-approved CED study
• The clinical trial number must be reported on the claim
• Report modifier Q0 or Q1, as appropriate

Resources

• CMS coverage with evidence development guidelines
• Implantable pulmonary artery pressure sensors for heart failure management CMS guidelines