Clinical review
For information concerning whether a specific service or benefit is covered, please refer to your Evidence of Coverage, or call Kaiser Permanente Member Services at 404-365-0966 or toll-free at 1-800-611-1811 (TTY 711).
The documents below are available to detail the review process and procedures:
A
- Abdominoplasty, Panniculectomy, & Lipectomy (PDF)
- Acupuncture (PDF)
- Autism (PDF)
B
- Benign Skin Lesion and Lipoma Removal (PDF)
- Biofeedback (Pelvic Rehab Therapy) (PDF)
- Breast Reduction Mammoplasty (PDF)
C
- Clinical Trials- Review Criteria (PDF)
- Compression Garments and Pneumatic Compression Garments (PDF)
- Continuous Glucose Monitors - Adults (PDF)
- Continuous Glucose Monitors - Pediatrics (PDF)
- CT Enterography (CTE) (PDF)
D
E
G
H
- Hardship Radiation (PDF)
- Home Health Services/Home Health Aides (PDF)
- Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (PDF)
I
M
- Meniett Device (Positive Pressure Pulse Generator) (PDF)
- Medicare Coverage Database (NCD/LCD/NCA) (PDF)
- Medicare Benefit Policy Manual: Chapter 1 - Inpatient Hospital, Inpatient Rehabilitation Facility (IRF), Long Term Acute Care (LTAC) (PDF)
- Medicare Benefit Policy Manual: Chapter 7- Home Health Services (PDF)
- Medicare Benefit Policy Manual- Chapter 8, Skilled Nursing Facility (PDF)
- Medicare Benefit Policy Manual: Chapter 15 Covered Medical and Other Health Services (PDF)
N
- Neuromuscular Electrical Stimulation NEMS/FES (PDF)
- Neuropsychological Evaluations (PDF)
- Non-Emergent Ambulance Transportation (PDF)
O
P
- Portable and Liquid Oxygen (PDF)
- Proton Beam Therapy (PDF)
R
- Regional Review Criteria for Home Health Services for Venipuncture for Lab Tests (PDF)
- Rolling Knee Walkers (Crutch Substitute) (PDF)
S
- Sclerotherapy, Vein Stripping or Endovenous Procedures for Varicose Veins (PDF)
- Scoliosis Back Brace Pediatric (PDF)
- Space OAR Hydrogel (PDF)
- Speech Therapy (PDF)
- Supervised Exercise Therapy (SET) for Intermittent (PDF)
T
- Therapeutic Shoes for Diabetics (PDF)
- Total Ankle Arthroplasty (PDF)
- Trilogy Ventilators for In-Home Use (PDF)
U
V