Coverage of Conditions and Treatments (Coverage Decisions)
Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.
List also available in PDF format.
See Treatment Guidelines and Resources for additional information.
Bronchial thermoplasty is a procedure designed to treat asthma that is not well-controlled by medication. Smooth muscle in the lungs is altered by placement of a radio frequency catheter that heats the muscle tissue, which is intended to reduce the likelihood of broncho constriction during an asthma reaction.
Bronchial thermoplasty is not a covered benefit. The decision is based on a Health Technology Clinical Committee (HTCC) coverage determination that was first reviewed in May 2016 and finalized on July 8, 2016. The committee's determination was based on a systematic review of the evidence for safety, efficacy and cost-effectiveness. Complete information on this HTCC determination is available here: What we're working on | Washington State Health Care Authority.
In adopting this HTCC coverage determination, the Department has concluded that the determination does not conflict with any state statute. Any coverage for investigational treatment would be considered per WAC 296-20-02850. Any coverage for health technologies that have a FDA Humanitarian Device Exemption status would be considered per RCW 70.14.120 (1) (b).