Medical Technologies Database


A comprehensive listing of medical technologies reviewed by the Medical Policy Committee for coverage consideration is available for download in Clinical Corner on our provider website. The database has been updated with new 2021 CPT/HCPCS codes, as needed.


  • FoundationOne® Liquid CDx (Medicare only) 
  • Per-oral endoscopic myotomy (POEM) for the treatment of swallowing disorders (e.g., achalasia) 
  • Prostate cancer antigen 3 gene (PCA 3) screening for prostate cancer (Progensa® PCA3 test [Hologic®]) (Added Commercial to already-covered Medicare)


  • Cala Trio™ electrical stimulation of the external upper limb and peripheral nerves of the wrist for essential tremor
  • Monarch external Trigeminal Nerve Stimulation [eTNS] System for pediatric attention deficit disorder (ADD)
  • PIGF Preeclampsia Screen (PerkinElmer Genetics)
  • PreTRM® (Sera Prognostics)
  • Precision Blood™ (San Diego Blood Bank) 
  • Patient Specific Talus Spacer 3D-printed talus implant
Provider Update