NEBULIZER MACHINES

Coverage Guidelines 

A small volume nebulizer and related compressor are considered for coverage when it is reasonable and necessary to administer the following FDA-approved inhalation solutions listed below:

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It is reasonable and necessary to administer albuterol, arformoterol, budesonide, cromolyn, formoterol, ipratropium, levalbuterol, metaproterenol, or revefenacin for the management of obstructive pulmonary disease or

It is reasonable and necessary to administer dornase alfa to a beneficiary with cystic fibrosis or

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It is reasonable and necessary to administer tobramycin to a beneficiary with cystic fibrosis or bronchiectasis or

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It is reasonable and necessary to administer pentamidine to a beneficiary with HIV, pneumocystosis, or complications of organ transplants or

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It is reasonable and necessary to administer acetylcysteine for persistent thick or tenacious pulmonary secretions