Medicare and Medicaid Resources

Structural Heart

Medicare is the largest public payer in the US. Since Medicare is a public insurance provider, their process is quite rigorous, and all of their rules must be posted for review. This section includes Medicare policies, rules, and memos for structural heart procedures.

Centers for Medicare and Medicaid Services

Transcatheter Valve Solutions

  • Developed through an evidence-based process, this policy provides details on required medical criteria that must be met for coverage of Medicare beneficiaries.

Occluders and Surgical Valves

  • Developed through an evidence-based process, this policy provides details on required medical criteria that must be met for coverage of Medicare beneficiaries.

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Health Economics & Reimbursement Disclaimer

This material and the information contained herein is for general information purposes only and is not intended, and does not constitute, legal, reimbursement, business, clinical, or other advice. Furthermore, it is not intended to and does not constitute a representation or guarantee of reimbursement, payment, or charge, or that reimbursement or other payment will be received. It is not intended to increase or maximize payment by any payer. Abbott makes no express or implied warranty or guarantee that the list of codes and narratives in this document is complete or error-free. Similarly, nothing in this document should be viewed as instructions for selecting any particular code, and Abbott does not advocate or warrant the appropriateness of the use of any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and claims submitted to third-party payers. In addition, the customer should note that laws, regulations, and coverage policies are complex and are updated frequently, and, therefore, the customer should check with its local carriers or intermediaries often and should consult with legal counsel or a financial, coding, or reimbursement specialist for any questions related to coding, billing, reimbursement, or any related issues. This material reproduces information for reference purposes only. It is not provided or authorized for marketing use.

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