Pressure Reducing Support Surfaces (CPB 0430, reviewed 2026-07-10)
Aetna's Clinical Policy Bulletin 0430 covers pressure-reducing support surfaces as durable medical equipment and sets separate criteria for group 1 mattresses and overlays, group 2 alternating pressure and low air loss surfaces, and group 3 air-fluidized beds. Group 2 surfaces are medically necessary when the member meets criteria such as having multiple stage II pressure ulcers on the trunk or pelvis after a comprehensive ulcer treatment program, having large or multiple stage III or IV ulcers on the trunk or pelvis, or having had a recent myocutaneous flap or skin graft. A support surface that does not prevent bottoming out is considered not medically necessary, and ordinary consumer-grade air mattresses are not covered because they do not meet Aetna's contractual definition of durable medical equipment.