mcgs.bcbsfl.comMedical Coverage Guideline

s Open the calendar popup. May 2024 S M T W T F S 18 28 29 30 1 2 3 4 19 5 6 7 8 9 10 11 20 12 13 14 15 16 17 18 21 19 20 21 22 23 24 25 22 26 27 28 29 30 31 1 23 2 3 4 5 6 7 8 Search What’s New Current Guidelines By Category Ambulance Ambulance Services Durable Medical Equipment Blood Glucose Monitors and Supplies Continuous Passive Motion Device Cooling and Heating Devices Used in the Outpatient Setting Durable Medical Equipment (DME) Electrostimulation and Electromagnetic Therapy for Treating Wounds External Infusion Pumps (non-insulin) External Insulin Infusion Pumps and Continuous Glucose Monitors Home Cardiorespiratory Monitoring, Infant Home Pulse Oximetry Home Spirometry Hospital Beds and Accessories Infrared Energy Therapy and Low Level Laser Therapy Mechanical Stretching Devices for Treatment of Joint Stiffness and Contractures Negative Pressure Wound Therapy (NPWT) Neuromuscular Electrical Stimulation (NMES) Non-Invasive Electrical Bone Growth Stimulators (EBGS) Noncontact Normothermic Wound Therapy Oscillatory Devices Used in the Home for the Treatment of Cystic Fibrosis and Other Respiratory Disorders Oxygen Percutaneous Electrical Nerve Stimulation (PENS) Pneumatic Compression Devices Positive Airway Pressure Devices Positive Pressure Ventilation in Adults Sacral Nerve Modulation Stimulation Speech Generating Devices Spinal Cord and Dorsal Root Ganglion Stimulation Transcutaneous Electric Nerve Stimulation (TENS) Transtympanic Micropressure Applications as a Treatment of Meniere’s Disease Tumor Treating Fields Therapy Ultrasound Osteogenesis Stimulators, Non-invasive Wheelchairs and Wheelchair Accessories Medicine Adoptive Immunotherapy Allergy Testing and Immunotherapy Ambulatory Blood Pressure Monitoring (ABPM) Apheresis, Plasmapheresis and Plasma Exchange Autonomic Nervous System Testing Balloon Dilation of the Eustachian Tube Biofeedback Cardiac Monitoring Devices Chelation Therapy Cognitive Rehabilitation Diabetic Self-Management Training and Educational Supplies Diagnosis and Treatment of Temporomandibular Joint Disorder Electroretinography Esophageal pH Monitoring Evoked Potentials, Intraoperative Neurophysiologic Monitoring, and Quantitative Electroencephalography (QEEG) External Counterpulsation (ECP) Extracorporeal Membrane Oxygenation (ECMO) for Adult Conditions Extracorporeal Photopheresis (ECP) Extracorporeal Shock Wave (ESW) Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions Extracorporeal Shock Wave Therapy in the Treatment of Peyronie’s Disease Fecal Microbiota Transplantation Foot Care Services Gastric Electrical Stimulation Home Prothrombin Time Monitoring Hyperbaric Oxygen Therapy (Systemic & Topical) Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Ingestible pH and Pressure Capsule Magnetoencephalography/Magnetic Source Imaging Minimally Invasive Procedures for the Treatment of Gastroesophageal Reflux Disease (GERD) and Dysphagia Nerve Conduction Studies, F-wave Studies, H-reflex Studies Neuropsychological Testing Orthopedic Applications of Stem-Cell Therapy Outpatient Medical Nutrition Therapy Outpatient Pulmonary Rehabilitation Pelvic Floor Stimulation as a Treatment of Incontinence Percutaneous and Subcutaneous Tibial Nerve Stimulation Physical Therapy (PT) and Occupational Therapy (OT) Preventive Services Psoralens Plus Ultraviolet A (PUVA) Therapy (Photochemotherapy) Quantitative Sensory Testing Signal Averaged Electrocardiography (SAECG) Sleep Testing Speech Therapy Services Thoracic Electrical Bioimpedance (TEB) Total Body Plethysmography Transanal Radiofrequency Therapy as a Treatment of Fecal Incontinence Transcranial Doppler Studies Transcranial Magnetic Stimulation Treatment of Autism Spectrum Disorders Treatment of Hyperhidrosis Treatment of Tinnitus Vestibular Rehabilitation Wearable and Non-Wearable Cardioverter-Defibrillators Wireless Capsule Endoscopy Orthotics and Prosthetics Cranial Orthosis for Craniosynostoses and Plagiocephaly Functional Neuromuscular Stimulation Knee Braces Lower Limb Microprocessor-Controlled Prosthetics Myoelectric Prosthetic and Orthotic Components for the Upper Limb Orthotics Prosthetics Other Enteral Formulas Home Health Care Home Parenteral Nutrition Hospice Care Injectable Bulking Agents for Treatment of Urinary and Fecal Incontinence Investigational Services Non-Covered Services Private Duty Nursing Care in the Home ProThelial for the Treatment of Oral Mucositis Technologies for the Evaluation of Malignant Melanoma Pathology and Laboratory Adjunctive Techniques for Screening and Surveillance of Barrett’s Esophagus and Esophageal Dysplasia Analysis of Human DNA as a Technique for Colorectal Cancer Screening Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer Drug Testing in Pain Management and Substance Use Disorder Treatment Fecal Analysis in the Diagnosis of Intestinal Dysbiosis Gene Expression Profile Testing and Circulating Tumor DNA Testing for Predicting Recurrence in Colon Cancer Genetic Testing Genetic Testing for BRCA1 or BRCA2 for Hereditary Breast Ovarian Cancer Syndrome and Other High Risk Cancers Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes In Vitro Chemoresistance and Chemosensitivity Assays Intracellular Micronutrient Analysis Laboratory Tests Post Transplant and for Heart Failure Measurement of Apolipoprotein B (apo B) and Apolipoprotein E (apo E) in Risk Assessment and Management of Cardiovascular Disease Molecular Testing for the Management of Pancreatic Cysts, Barrett Esophagus, and Solid Pancreatic Lesions Noninvasive Prenatal Screening for Fetal Aneuploidies, Twin Zygosity, and Microdeletions Using Cell-Free Fetal DNA Somatic Biomarker Testing (KRAS, NRAS, BRAF, HER2), Including Liquid Biopsy and MicroRNA Expression Testing, in Metastatic Colorectal Cancer Sparsentan (Filspari) Tumor/Genetic Markers Pharmacy Abaloparatide (Tymlos) Abatacept (Orencia) Injection and Infusion Abemaciclib (Verzenio) Abiraterone Acetate (Yonsa, Zytiga) Tablet Abrocitinib (Cibinqo) Tablets Acalabrutinib (Calquence) Oral Adalimumab Products (Humira and biosimilars) ADAMTS13 recombinant-krhn (Adzynma) IV Infusion Ado-trastuzumab emtansine (Kadcyla) Aducanumab-avwa (Aduhelm) Afamelanotide (Scenesse) Implant Afatinib (Gilotrif) Tablets Agalsidase Beta (Fabrazyme) IV Alectinib (Alecensa) Alemtuzumab (Lemtrada) IV Allogeneic Processed Thymus Tissue_agdc (Rethymic) Alpelisib (Piqray) Tablet Alpelisib (Vijoice) Alpha1-Proteinase Inhibitors (Human) Amifampridine Phosphate (Firdapse) Amivantamab-vmjw (Rybrevant) Anakinra (Kineret) Injection Anifrolumab-fnia (Saphnelo) IV Infusion Apalutamide (Erleada) Tablet Apremilast (Otezla) Tablet Aprepitant injectable therapy (Cinvanti) Asciminib (Scemblix) Tablet Asfotase alfa (Strensiq) Atidarsagene autotemcel (Lenmeldy) suspension for IV infusion Avacincaptad pegol (Izervay) intravitreal injection Avacopan (Tavneos) Avapritinib (Ayvakit) Avatrombopag (Doptelet) Axicabtagene Ciloleucel (Yescarta) Infusion Axitinib (Inlyta) Tablets Azacitidine (Vidaza) Injection Baricitinib (Olumiant) Tablet Belantamab Mafodotin-blmf (Blenrep) IV Infusion Belimumab (Benlysta) Injection Belinostat (Beleodaq) Injection Belumosudil (Rezurock) Tablets Bendamustine HCl Injection Benralizumab (Fasenra) Beremagene Geperpavec-svdt (Vyjuvek) Biological Suspension Betaine, anhydrous (Cystadane) Oral Solution Betibeglogene Autotemcel (Zynteglo) IV Infusion Bevacizumab (Avastin), bevacizumab-awwb (Mvasi), bevacizumab-bvzr (Zirabev), and bevacizumab-maly (Alymsys), bevacizumab-tnjn (Avzivi), and bevacizumab-adcd (Vegzelma) Injection Bexarotene (Targretin) Capsules Bezlotoxumab (Zinplava) Injection Bimekizumab (Bimzelx) Injection Binimetinib (Mektovi) Tablet Blinatumomab (Blincyto) IV Bortezomib (Velcade) Injection Bosutinib (Bosulif) Capsules and Tablets Botulinum Toxins Brand (Aubagio) Tablet Brand Gilenya Capsule and Tascenso ODT Brand Tecfidera,...