• Actigraphy
• Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms
• Allogeneic Pancreas Transplant
• Ambulance (Emergency)
• Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry
• Amniotic Membrane and Amniotic Fluid
• Anesthesia for Dental Procedures
• Antigen Leukocyte Antibody Test
• Aqueous Shunts and Stents for Glaucoma
• Artificial Intervertebral Disc: Cervical Spine
• Artificial Intervertebral Disc: Lumbar Spine
• Artificial Pancreas Device Systems
• Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
• Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
• Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
• Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non-Orthopedic Conditions
• Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure
• Automated Percutaneous and Percutaneous Endoscopic Discectomy
• Autonomic Nervous System Testing
• Axial Lumbosacral Interbody Fusion

• Balloon Dilation of the Eustachian Tube
• Balloon Ostial Dilation for Treatment of Chronic and Recurrent Acute Rhinosinusitis
• Bariatric Surgery
• BCR-ABL1 Testing in Chronic Myelogenous Leukemia and Acute Lymphoblastic Leukemia
• Bioengineered Skin and Soft Tissue Substitutes
• Biofeedback as a Treatment of Chronic Pain
• Biofeedback as a Treatment of Fecal Incontinence or Constipation
• Biofeedback as a Treatment of Headache
• Biofeedback as a Treatment of Urinary Incontinence in Adults
• Biofeedback for Miscellaneous Indications
• Bioimpedance Devices for Detection and Management of Lymphedema
• Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment and Immunotherapy in Breast Cancer
• Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment and Immunotherapy in Metastatic Colorectal Cancer
• Biventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure
• Blepharoplasty
• Bronchial Thermoplasty

• Cardiac Rehabilitation in the Outpatient Setting
• Cardiovascular Risk Panels
• Carrier Screening for Genetic Diseases
• Catheter Ablation as Treatment for Atrial Fibrillation
• Chelation Therapy for Off-Label Uses
• Chromosomal Microarray Testing for the Evaluation of Pregnancy Loss
• Circulating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy)
• Closure Devices for Patent Foramen Ovale and Atrial Septal Defects
• Cochlear Implant
• Cognitive Rehabilitation
• Comprehensive Genomic Profiling for Selecting Targeted Cancer Therapies
• Computed Tomography Perfusion Imaging of the Brain
• Computer-Assisted Navigation for Orthopedic Procedure
• Confocal Laser Endomicroscopy
• Continuous or Intermittent Monitoring of Glucose in Interstitial Fluid
• Continuous Passive Motion in the Home Setting
• Cooling Devices Used in the Outpatient Setting
• Corneal Topography/Computer-Assisted Corneal Topography/Photokeratoscopy
• Cosmetic vs. Reconstructive Surgery or Services
• Cranial Electrotherapy Stimulation and Auricular Electrostimulation
• Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
• Cryosurgical Ablation of Primary or Metastatic Liver Tumors
• Cytochrome P450 Genotype-Guided Treatment Strategy

• Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)
• Deep Brain Stimulation
• Dermatologic Applications of Photodynamic Therapy
• Diagnosis and Management of Idiopathic Environmental Intolerance and Intracellular Micronutrient Analysis
• Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome
• Diagnosis and Treatment of Sacroiliac Joint Pain
• Discectomy
• Dopamine Transporter Single-Photon Emission Computed Tomography
• Dynamic Posturography
• Dynamic Spinal Visualization and Vertebral Motion Analysis

• Electrical and Electromagnetic Stimulation for the Treatment of Arthritis
• Electrical Bone Growth Stimulation of the Appendicular Skeleton
• Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures
• Electromagnetic Navigation Bronchoscopy
• Electrostimulation and Electromagnetic Therapy for Treating Wounds
• Endobronchial Ultrasound for Diagnosis and Staging of Lung Cancer
• Endoscopic Radiofrequency Ablation or Cryoablation for Barrett Esophagus
• Endothelial Keratoplasty
• Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms)
• Endovascular Stent Grafts for Abdominal Aortic Aneurysms
• Endovascular Therapies for Extracranial Vertebral Artery Disease
• Enhanced External Counterpulsation
• Epidural Steroid Injections for Neck or Back Pain
• Extracorporeal Photopheresis
• Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions
• Extracranial Carotid Artery Stenting
• Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome

• Facet Arthroplasty
• Facet Joint Denervation
• Fecal Analysis in the Diagnosis of Intestinal Dysbiosis
• Fecal Calprotectin Testing
• Fecal Microbiota Transplantation
• Functional Neuromuscular Electrical Stimulation

• Gastric Electrical Stimulation
• Gender Affirmation Surgery
• Gene Expression Profile Testing and Circulating Tumor DNA Testing for Predicting Recurrence in Colon Cancer
• Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management
• Gene Expression Profiling for Cutaneous Melanoma
• Gene Expression-Based Assays for Cancers of Unknown Primary
• Gene Variants Associated With Breast Cancer in Individuals at High Breast Cancer Risk
• General Approach to Evaluating the Utility of Genetic Panels
• General Approach to Genetic Testing
• Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
• Genetic Cancer Susceptibility Panels Using Next-Generation Sequencing
• Genetic Testing for Alpha1-Antitrypsin Deficiency
• Genetic Testing for Alzheimer Disease
• Genetic Testing for Cardiac Ion Channelopathies
• Genetic Testing for Developmental Delay/Intellectual Disability, Autism Spectrum Disorder, and Congenital Anomalies
• Genetic Testing for Diagnosis and Management of Mental Health Conditions
• Genetic Testing for Duchenne and Becker Muscular Dystrophy
• Genetic Testing for Epilepsy
• Genetic Testing for Familial Cutaneous Malignant Melanoma
• Genetic Testing for FLT3, NPM1, and CEBPA Variants in Cytogenetically Normal Acute Myeloid Leukemia
• Genetic Testing for FMR1 Variants (Including Fragile X Syndrome)
• Genetic Testing for Hereditary Hearing Loss
• Genetic Testing for Hereditary Hemochromatosis
• Genetic Testing for Hereditary Pancreatitis
• Genetic Testing for Idiopathic Dilated Cardiomyopathy
• Genetic Testing for Lactase Insufficiency
• Genetic Testing for Li-Fraumeni Syndrome
• Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes
• Genetic Testing for Marfan Syndrome, Thoracic Aortic Aneurysms and Dissections, and Related Disorders
• Genetic Testing for Mitochondrial Disorders
• Genetic Testing for Predisposition to Inherited Hypertrophic Cardiomyopathy
• Genetic Testing for PTEN Hamartoma Tumor Syndrome
• Genetic Testing for Rett Syndrome
• Genetic Testing for Statin-Induced Myopathy
• Genetic Testing for the Diagnosis of Inherited Peripheral Neuropathies
• Genetic Testing of CADASIL Syndrome
• Genotype-Guided Tamoxifen Treatment
• Genotype-Guided Warfarin Dose
• Germline and Somatic Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment and Immunotherapy in Breast Cancer
• Germline Genetic Testing for BRCA1 or BRCA2 for Hereditary Breast/Ovarian Cancer Syndrome and Other High-Risk Cancers
• Germline Genetic Testing for Pancreatic Cancer Susceptibility Genes

• Heart Transplant
• Heart/Lung Transplant
• Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia
• Hematopoietic Cell Transplantation for Acute Myeloid Leukemia
• Hematopoietic Cell Transplantation for Autoimmune Diseases
• Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma
• Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
• Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia
• Hematopoietic Cell Transplantation for Epithelial Ovarian Cancer
• Hematopoietic Cell Transplantation for Hodgkin Lymphoma
• Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults
• Hematopoietic Cell Transplantation for Non-Hodgkin Lymphomas
• Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome
• Hematopoietic Cell Transplantation for Primary Amyloidosis
• Hematopoietic Cell Transplantation for Solid Tumors of Childhood
• Hematopoietic Cell Transplantation in the Treatment of Germ Cell Tumors
• Hip Resurfacing
• Hippotherapy
• Homocysteine Testing in the Screening, Diagnosis, and Management of Cardiovascular Disease and Venous Thromboembolic Disease
• Human Leukocyte Antigen Testing for Celiac Disease
• Hyperbaric Oxygen Therapy
• Hyperthermic Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies

• Image-Guided Minimally Invasive Decompression for Spinal Stenosis
• Immune Cell Function Assay
• Implantable Bone-Conduction and Bone-Anchored Hearing Aids
• Implantable Cardioverter Defibrillators
• Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence
• Intensity-Modulated Radiotherapy: Abdomen and Pelvis
• Intensity-Modulated Radiotherapy: Cancer of the Head and Neck or Thyroid
• Intensity-Modulated Radiotherapy: Central Nervous System Tumors
• Intensity-Modulated Radiotherapy of the Breast and Lung
• Intensity-Modulated Radiotherapy of the Prostate
• Interspinous and Interbody Fixation (Fusion) Devices
• Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
• Intra-Articular Hyaluronan Injections for Osteoarthritis
• Intracavitary Balloon Catheter Brain Brachytherapy for Malignant Gliomas or Metastasis to the Brain
• Intradialytic Parenteral Nutrition
• Intraoperative Neurophysiologic Monitoring
• Invasive Prenatal (Fetal) Diagnostic Testing
• Islet Transplantation
• Isolated Small Bowel Transplant

• JAK2, MPL, and CALR Testing for Myeloproliferative Neoplasms

• Keratoprosthesis
• Kidney Transplant

• Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients With Cancer
• Laboratory Tests Post Transplant and for Heart Failure
• Laminectomy
• Laparoscopic, Percutaneous, and Transcervical Techniques for Uterine Fibroid Myolysis
• Leadless Cardiac Pacemakers
• Liver Transplant and Combined Liver-Kidney Transplant
• Low Intensity Pulsed Ultrasound Fracture Healing Device
• Low-Level Laser Therapy
• Lumbar Spinal Fusion
• Lung and Lobar Lung Transplant
• Lung Volume Reduction Surgery for Severe Emphysema

• Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease
• Magnetic Resonance Imaging‒Targeted Biopsy of the Prostate
• Magnetic Resonance-Guided Focused Ultrasound
• Manipulation Under Anesthesia
• Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis and Management of Respiratory Disorders
• Measurement of Serum Antibodies to Selected Biologic Agents
• Meniscal Allografts and Other Meniscal Implants
• Microarray-Based Gene Expression Profile Testing for Multiple Myeloma Risk Stratification
• Microprocessor-Controlled Prostheses for the Lower Limb
• Microwave Tumor Ablation
• Miscellaneous Genetic and Molecular Diagnostic Tests
• Molecular Analysis (Including Liquid Biopsy) for Targeted Therapy or Immunotherapy of Non-Small-Cell Lung Cancer
• Molecular Markers in Fine Needle Aspirates of the Thyroid
• Molecular Testing for Germline BRIP1, RAD51C, and RAD51D Variants Associated with Ovarian Cancer
• Molecular Testing for the Management of Pancreatic Cysts, Barrett Esophagus, and Solid Pancreaticobiliary Lesions
• Multibiomarker Disease Activity Blood Test for Rheumatoid Arthritis
• Multimarker Serum Testing Related to Ovarian Cancer
• Myocardial Strain Imaging
• Myoelectric Prosthetic and Orthotic Components for the Upper Limb

• Negative Pressure Wound Therapy in the Outpatient Setting
• Nerve Graft With Radical Prostatectomy
• Neurofeedback
• Noninvasive Prenatal Screening for Fetal Aneuploidies, Microdeletions, and Twin Zygosity Using Cell-Free Fetal DNA
• Noninvasive Techniques for the Evaluation and Monitoring of Patients With Chronic Liver Disease
• Novel Biomarkers in Risk Assessment and Management of Hyperlipidemia in Cardiovascular Disease

• Occipital Nerve Stimulation
• Office-Based Orthoptic Training for the Treatment of Vision or Learning Disabilities
• Oncologic Applications of Photodynamic Therapy, Including Barrett Esophagus
• Open and Thoracoscopic Approaches to Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures)
• Optical Coherence Tomography of the Anterior Eye Segment
• Orthognathic Surgery
• Orthopedic Applications of Platelet-Rich Plasma
• Orthopedic Applications of Stem Cell Therapy (Including Allografts and Bone Substitutes Used With Autologous Bone Marrow)
• Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions
• Outpatient Pulmonary Rehabilitation
• Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion Syndrome

• Panniculectomy, Abdominoplasty, and Excision of Redundant Skin
• Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
• Percutaneous Balloon Kyphoplasty, Radiofrequency Kyphoplasty, and Mechanical Vertebral Augmentation
• Percutaneous Electrical Nerve Stimulation and Percutaneous Neuromodulation Therapy
• Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, and Biacuplasty
• Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
• Percutaneous Tibial Nerve Stimulation
• Percutaneous Vertebroplasty and Sacroplasty
• Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux
• Pharmacogenetic Testing for Pain Management
• Pharmacogenomic and Metabolite Markers for Patients Treated With Thiopurines
• Photodynamic Therapy for Choroidal Neovascularization
• Plugs for Anal Fistula Repair
• Pneumatic Compression Pumps for Treatment of Lymphedema and Venous Ulcers
• Polysomnography for Non-respiratory Sleep Disorders
• Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis
• Preimplantation Genetic Testing
• Progenitor Cell Therapy for the Treatment of Damaged Myocardium due to Ischemia
• Prolotherapy
• Prostatic Urethral Lift

• Quantitative Sensory Testing

• Radioembolization for Primary and Metastatic Tumors of the Liver
• Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
• Radiofrequency Ablation of Primary or Metastatic Liver Tumors
• Reconstructive Breast Surgery/Management of Breast Implants
• Reduction Mammaplasty for Breast-Related Symptoms

• Sacral Nerve Neuromodulation/Stimulation
• Saturation Biopsy for Diagnosis, Staging, and Management of Prostate Cancer
• Scintimammography and Gamma Imaging of the Breast and Axilla
• Semi-Implantable and Fully Implantable Middle Ear Hearing Aids
• Sensory Integration Therapy and Auditory Integration Therapy
• Serologic Genetic and Molecular Screening for Colorectal Cancer
• Small Bowel/Liver and Multivisceral Transplant
• Sphenopalatine Ganglion Block for Headache
• Spinal Cord and Dorsal Root Ganglion Stimulation
• Stem Cell Therapy for Peripheral Arterial Disease
• Stereotactic Radiosurgery and Stereotactic Body Radiotherapy
• Steroid-Eluting Sinus Stents
• Subtalar Arthroereisis
• Surgical Treatment of Bilateral Gynecomastia
• Surgical Treatment of Femoroacetabular Impingement
• Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome
• Surgical Ventricular Restoration

• Targeted Phototherapy and Psoralen with Ultraviolet A for Vitiligo
• Technology Assessment and Medically Necessary Services
• Temporomandibular Joint Dysfunction
• Thermography
• Total Artificial Hearts and Implantable Ventricular Assist Devices
• Transcatheter Aortic Valve Implantation for Aortic Stenosis
• Transcatheter Arterial Chemoembolization to Treat Primary or Metastatic Liver Malignancies
• Transcatheter Mitral Valve Repair
• Transcatheter Pulmonary Valve Implantation
• Transcutaneous Electrical Nerve Stimulation
• Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease
• Transmyocardial Revascularization
• Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic Hyperplasia
• Treatment of Hyperhidrosis
• Treatment of Tinnitus
• Treatment of Varicose Veins/Venous Insufficiency
• Tumor Treating Fields Therapy

• Urinary Biomarkers for Cancer Screening, Diagnosis, and Surveillance
• Use of Common Genetic Variants (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer

• Vagus Nerve Stimulation
• Vertebral Axial Decompression
• Vestibular Function Testing
• Viscocanalostomy and Canaloplasty

• Wearable Cardioverter Defibrillators
• Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders
• Whole Gland Cryoablation of Prostate Cancer
• Wireless Capsule Endoscopy to Diagnose Disorders of the Small Bowel, Esophagus, and Colon