Question: Where can I find Medicare’s coverage rules for leadless pacemakers?
Pennsylvania Subscriber
Answer: Medicare recently posted a decision memo at this site: www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=285. It should be available in the National Coverage Determinations manual soon.
CMS covers leadless pacemakers through Coverage with Evidence Development (CED), meaning the service must be part of a CMS-approved study for Medicare to cover the service.
You’ll find the codes for leadless pacemakers in Category III, 0387T-0391T.