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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

July 2014

New Medical Policy for Pulse Oximeters

Harvard Pilgrim has established a medical policy on pulse oximeters that details which types of pulse oximeters are eligible for reimbursement. Effective October 1, 2014, Harvard Pilgrim will reimburse only for the purchase of medically necessary fingertip pulse oximeters that have the following capabilities:

  • Digital display
  • Monitors blood oxygen saturation rate
  • Monitors pulse rate

Pulse oximeters with additional functionality and capabilities (for example devices with extended memory or table-top or hand-held devices) are not considered medically necessary and are not eligible for reimbursement. To obtain reimbursement and pricing information on pulse oximeters, please contact the Provider Service Center at 800-708-4414.

Pulse oximeters are used to measure oxygen level in the blood, and Harvard Pilgrim considers fingertip pulse oximeters to be medically necessary for some members with respiratory and oxygen management issues.

For complete information, please refer to Harvard Pilgrim’s Pulse Oximeters Clinical Medical Policy.

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Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,

Kristin Edmonston,
Production Coordinator