E0665 commercial payer coverage policies

15 commercial payer policies list E0665. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Commercial payer policies listing E0665

15 policies from 10 payers

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Anthem

Anthem policies listing E0665, with the code’s status in each
Policy	Effective	Status of E0665
Compression Devices for LymphedemaClinical Guideline · ANTHEM-CG-DME-06	Jan 6, 2026	Covered
Pneumatic Compression Devices for Prevention of Deep Vein Thrombosis of the Extremities in the Home SettingClinical Guideline · ANTHEM-CG-DME-46	Jul 1, 2026	Not covered

BCBS Illinois

BCBS Illinois policies listing E0665, with the code’s status in each
Policy	Effective	Status of E0665
Compression Pumps for Treatment of Lymphedema and Venous UlcersPayerPolicy · BCBSIL-MED202.060	Jan 1, 2026	Covered
Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism ProphylaxisPayerPolicy · BCBSIL-MED202.073	Sep 1, 2026	Covered

E0665 commercial payer coverage policies

Commercial payer policies listing E0665

Anthem

BCBS Illinois

E0665 commercial payer coverage policies

Commercial payer policies listing E0665

Anthem

BCBS Illinois

BCBS Montana

BCBS New Mexico

BCBS Oklahoma

Cigna

Regence BCBS

Surest (UnitedHealthcare)

UMR (UnitedHealthcare)

UnitedHealthcare