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Medicare Medical Guidelines - Categorical Index

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Drugs
High-tech Diagnostic Imaging
Home Health/Durable Medical Equipment
Medical
Mental Health
Other Treatments
Reimbursement
Surgery
Therapy

Drugs

Alymsys Part B Step Therapy
Avastin Part B Step Therapy
Cinqair (reslizumab)
Empaveli Part B Prior Authorization
Enspryng Part B Prior Authorization
Fasenra (benralizumab)
Fulphila Part B Step Therapy
Granix Part B Step Therapy
Herceptin Hylecta Part B Step Therapy
Herceptin Part B Step Therapy
Herzuma Part B Step Therapy
Immune Globulins Part B Prior Authorization
Immunoglobulin Therapy (Intravenous and Subcutaneous) in the Home
Immunosuppressants Medications
Intra-articular Hyaluronan Injections Criteria
IV Iron Agents
Kanjinti Part B Prior Authorization
Krystexxa Part B Prior Authorization
Lemtrada (alemtuzumab)
Leukine Part B Prior Authorization
Mvasi Part B Prior Authorization
Nebulizer Medications
Neulasta/Neulasta OnPro Part B Step Therapy
Neupogen Part B Step Therapy
Nivestym Part B Prior Authorization
Nucala (mepolizumab)
Nyvepria Part B Step Therapy
Ocrevus (ocrelizumab)
Ocular Angiogenesis Inhibitors
Ogivri Part B Prior Authorization
Ontruzant Part B Step Therapy
Oral Anticancer Medications
Oral Antiemetic Medications
Reblozyl Part B Prior Authorization
Releuko Part B Step Therapy
Riabni Part B Step Therapy
Rituxan Hycela Part B Step Therapy
Rituxan Part B Step Therapy
Ruxience Part B Prior Authorization
Soliris Part B Step Therapy
Tepezza Part B Prior Authorization
Truxima Part B Prior Authorization
Tysabri (natalizumab)
Udenyca Part B Prior Authorization
Ultomiris Part B Prior Authorization
Uplinza Part B Prior Authorization
Vyvgart Part B Prior Authorization
Xolair (omalizumab)
Zarxio Part B Prior Authorization
Ziextenzo Part B Prior Authorization
Zirabev Part B Prior Authorization

Medical

Ambulance and Medical Transport Services
Clinical Trial Services
Dental Services
Forsee Home AMD Monitoring
Investigational (Experimental) Services
Observation Services
Peripheral Nerve Stimulation and Peripheral Nerve Field Stimulation

Surgery

Breast Implant Removal
Breast Reduction
Deep Brain Stimulation for Essential Tremor and Parkinson
Dermabrasion
Electrical Stimulators - Spinal Cord
Lung Volume Reduction Surgery
Mitral Valve Transcatheter Edge to Edge Repair (TEER)
Morbid Obesity Surgery
Orthognathic Surgery
Percutaneous Left Atrial Appendage Closure
Reconstructive Eyelid Surgery
Refractive Surgical Procedures
Sacral Nerve Stimulator for Urinary Incontinence and Fecal Incontinence
Surgical Treatment of Obstructive Sleep Apnea
Temporomandibular Joint Surgery (TMJ)
Transcatheter Aortic Valve Replacement (TAVR)
Transplant Solid Organ
Transplant Stem Cell
Vagus Nerve Stimulators (VNS)
Varicose Vein Treatment
Ventricular Assist Device
Vertebroplasty and Percutaneous Vertebral Augmentation

Home Health/Durable Medical Equipment

Durable Medical Equipment
Electrical Stimulators - Osteogenesis
Electrical Stimulators - TENS
Electrical Stimulators: Neuromuscular
External Infusion Pumps
Orthotics Knee Orthoses
Orthotics: Ankle -Foot (AFO) and Knee-Ankle-Foot (KAFO) Orthoses
Orthotics: Lumbar Sacral Orthoses (LSO) and Thoracic Lumbar Sacral Orthoses (TLSO)
Oxygen and Oxygen Supplements
Penile Implants
Pneumatic Compression Device
Respiratory Assist Devices for Obstructive Sleep Apnea and Breathing Related Sleep Disorders
Upper Limb Prosthetics

Mental Health

Neuropsychological Testing
Psychological Evaluation and Testing
Transcranial Magnetic Stimulation Treatment

Therapy

Positive Airway Pressure Therapy For Obstructive Sleep Apnea and Breathing Related Sleep Disorders
Rehabilitation Therapy - Inpatient
Speech Language Pathology (SLP) Services
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