procedures for durable medical equipment and medical supply items and services. This handbook provides information on which items require prior approval and how to obtain prior approval. Providers will be held responsible for compliance with all policy and procedures contained herein.
Learn how breast prosthesis coverage work with Medicare. Find out if post-surgical bras, mastectomy, inpatient costs are covered under Medicare.
The policy provides for clearly written, reasonable and current criteria that have been approved by Health Net's National Medical Advisory Council (MAC). The clinical criteria and medical policies provide guidelines for determining the medical necessity criteria for specific procedures, equipment and services.