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ACG
​
h.o.l.M.E.S.

Automated Clinical Guidelines

DME-Devices

Indicates Non-covered Service

Air Conduction Hearing Aids
Airway Clearance Devices
Apnea Monitors for Infants
Artificial Pancreas Device System
Automated Insulin Delivery Devices
Automatic External Defibrillators
Autotransfusers
Humana
Aetna
Aetna
Blood Glucose Monitors & Supplies
Bowel Management Devices
Cervical Traction Devices
Continuous Glucose Monitoring Systems
Electric Breast Pumps
Electrical Nerve Stimulation, Transcutaneous, Percutaneous
Electrical Stimulation for Pain
FlorideBlue
Aetna
Aetna
Aetna
Cigna
Anthem
Anthem
Aetna
Cigna
ExcelsiorBlue
FlorideBlue
HighmarkBlue
Humana
HealthNet
Medicare
UHC
Electro-stimulation and Electromagnetic Therapy for Treating Wounds
Neuromuscular Electrical Stimulation (NMES)
Percutaneous Electrical Nerve Stimulation (PENS)
External Continuous Insulin Infusion Pumps
External Infusion Pumps  (non-insulin)
FlorideBlue
FlorideBlue
FlorideBlue
FlorideBlue
High Frequency Chest Wall Oscillation Devices
Implantable Bone Conduction and Bone-Anchored Hearing Aids
Implantable Continuous Glucose Monitors (I-CGM)
Infant Home Apnea Monitors
Infant Home Cardiorespiratory Monitoring
Mechanical In-exsufflation Devices
Nebulizers
FlorideBlue
Medicare
FlorideBlue
Negative Pressure Wound Therapy (NPWT) Pumps Inpatient-OutPatient
Negative Pressure Wound Therapy (NPWT)
Vacuum Assisted Wound Therapy in the Outpatient Setting
Neuromuscular Stimulation in the Treatment of Muscle Atrophy
Oral appliances for obstructive sleep apnea
NonInvasive Ultrasound Osteogenesis Stimulators
Medicare
FloridaBlue
Aetna
commercial
FlorideBlue
Humana
Medicare
Positive Pressure Ventilation
Respiratory Assist Devices
Speech Generating Devices
Suction Pump
Prothrombin Time Self-Monitoring Devices
Transtympanic Micropressure Applications as a Treatment of Meniere's Disease
Electrical and Ultrasound Bone Growth Stimulators
FlorideBlue
FlorideBlue
Anthem
UHC

Indicates Non-covered Service

highfreq2.jpg
Transtympanic Micropressure Applications as a Treatment of Meniere's Disease
 Intrapulmonary Percussive Ventilation Devices
FloridaBlue
Anthem
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