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Insurance Coverage

We assist patients in determining what insurance coverage they have for the Athena PMT.  Call our customer service at 1-866-308-4436

Codes:

HCPCS:  E0740

CPT Code:  97032, 97030

Medicare covers 80%.  The patient must have a four week trial of pelvic muscle exercises.

United Health- it depends on the patients DME coverage.  Usually a deductible needs to be met.

Kaiser Northern California- Definitely for their Medicare patients and depending on clinical review for others

Aetna- Covers PMT’s depending on DME coverage.

Health Choice- they cover between 20%-50% after deductible is reached

Blue Shield- Cover’s PMT’s depending on DME coverage.

 

If your patient would like to check if her insurance plan covers the Athena PMT here are some questions to ask:

    -Do I have DME (Durable Medical Equipment) coverage with my plan?

    -What is my deductible both in and out of network?

    -How much of my deductible have I met both for in and out of network?

    -The HCPCS (Hicpic) code is E0740.  Is that a covered code?

    -Does this require a pre authorization, if so where do I send that, what information do you need, and how long will it take to receive a determination.