High impact
Dialysis (CPB 0541, reviewed 2025-11-26)
Aetna·Effective Nov 26, 2025
Aetna's Dialysis policy (CPB 0541) was reviewed on 2025-11-26 and establishes medical necessity criteria for hemodialysis, peritoneal dialysis, home dialysis equipment/supplies, and vascular access procedures. The policy covers standard dialysis up to 3 times weekly, specialized dialysis for specific conditions, home hemodialysis with nursing support, and FDA-approved portable systems (NxStage, Tablo). Several experimental technologies are explicitly non-covered, including bioengineered vessels, EchoSure systems, vitamin E-coated membranes, and wearable hemodialysis machines.