Custom Fit Durable Medical Equipment (DME) - DME.CU.102.A
Effective Oct 27, 2025
2,954 active EviCore by Evernorth policies in Backwork, grouped by policy type. Each policy page shows the codes the policy lists and links to the payer’s own copy.
Summary of the payer’s published policy. Not a coverage determination — confirm with EviCore by Evernorth before submitting.
Free account. Policy pages stay open to everyone.
751–800 of 2,954, by type and title
Effective Oct 27, 2025
Effective Dec 1, 2020
Effective Dec 1, 2018
Effective Oct 1, 2022
Effective Nov 1, 2019
Effective Nov 1, 2021
Effective Aug 1, 2025
Effective Jan 1, 2024
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Effective Sep 1, 2020
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Effective Jun 1, 2017
Effective Feb 1, 2026
Effective Nov 1, 2025
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Effective Dec 1, 2018
Effective Oct 27, 2025
Effective May 1, 2025
Effective Dec 1, 2019
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Effective Mar 1, 2025
Effective Nov 1, 2025
Effective Jan 11, 2018