CommercialCoverageMedium impact
Home Automatic External Defibrillators (AEDs) and Wearable Cardioverter Defibrillators (WCDs) 1.01.42
Excellus BlueCross BlueShield·Cardiology, Internal Medicine, Family Medicine +2 more·Heart & Blood Vessels (Cardiovascular)
Effective date
Jun 26, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has updated their medical policy for Home Automatic External Defibrillators (AEDs) and Wearable Cardioverter Defibrillators (WCDs), effective June 26, 2025. The policy defines specific medical appropriateness criteria for WCDs as interim treatment for patients requiring ICD explantation, awaiting heart transplant, or as bridge therapy, and establishes coverage criteria for home AEDs when patients meet ICD criteria but have contraindications to implantation.
Action Required
Before June 26, 2025: Billing team must review and update prior authorization procedures for WCD and home AED claims to ensure compliance with new medical appropriateness criteria. Providers must document specific indications including LVEF measurements, cardiac workup results, prescribed wear time, and care plans addressing ICD placement. For WCD coverage beyond 60 days, ensure documentation includes compliance reporting and re-assessment of medical condition.