The Centers for Medicare and Medicaid Services (CMS) provides coverage for Esophageal Doppler Monitoring (EDM) under section 220.5 of the National Coverage Determination (NCD) Ultrasound Diagnostic Procedures. CMS determined that EDM is “reasonable and necessary” for all Medicare beneficiaries who meet the criteria for the following patient populations:

      • Monitoring of cardiac output (Esophageal Doppler) for ventilated patients in the ICU; and
      • Major surgery with an anticipate blood loss of greater than 500mls.

CMS’s decision was based in part on a technology assessment from the Agency for Healthcare Research and Quality (AHRQ) that concluded that in “patients undergoing surgical procedures with an expected substantial blood loss or fluid compartment shifts requiring fluid replacement” the clinical evidence for the use of EDM in the above patient populations was strong.