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24.5.20 Continuous Passive Motion (CPM) Device
A CPM device may be considered for prior authorization through Home Health Services. Reimbursement for a CPM device is considered after joint surgery, such as knee replacement, when prescribed by a physician and submitted with clinical documentation of medical necessity/appropriateness.
A CPM device is reimbursed on a daily basis and is limited to once per day. Reimbursement includes delivery, set-up and all supplies. Use procedure code L-E0935 when billing for a CPM machine.
Note: THSteps eligible clients who qualify for medically necessary services beyond the limits of this Home Health Services benefit may be considered under THSteps-CCP.
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