CommercialCoverageMedium impact
Continuous Passive Motion Device (CPM) in the Home Setting 1.01.02
Excellus BlueCross BlueShield·Orthopedics, PM&R (Physical Medicine & Rehab), Physical Therapy·Durable Medical Equipment & Supplies
Effective date
Oct 16, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their Continuous Passive Motion (CPM) device policy effective October 16, 2025, establishing specific coverage criteria for home CPM devices following knee surgeries including total knee arthroplasty, ACL reconstruction, and certain fracture repairs. Coverage is limited to 21 days post-operatively and excludes CPM for other joints and stationary cycling devices.
Action Required
By October 16, 2025: Billing team must update prior authorization processes for CPM device orders to verify qualifying surgical procedures (total knee arthroplasty, ACL reconstruction, ORIF of tibial plateau/distal femur fractures, or knee arthrofibrosis release). Ensure documentation includes evidence of low postoperative mobility, inability to comply with rehabilitation exercises, or non-weight bearing status. Do not authorize CPM beyond 21 days post-operatively or for non-knee joints as these will be denied as not medically necessary.