Catheter Ablation for Atrial Fibrillation
Defines medical necessity and coding guidance for catheter ablation procedures to treat atrial fibrillation for UnitedHealthcare Commercial and Individual Exchange members aged 18 and older.
No material clinical or coverage changes in this revision.
Coverage Criteria for Catheter Ablation
Medical necessity (InterQual referenced)
Covered when InterQual CP electrophysiology catheter ablation criteria are met.
Policy defers to InterQual criteria for specific clinical thresholds and decision logic
This policy excludes members aged < 18 years and arrhythmias other than atrial fibrillation. See the Coverage Rationale for the age and arrhythmia restrictions that define the population to which this policy applies.
The document does not list discrete scenarios labeled as "not medically necessary." Instead, coverage determinations for catheter ablation rely on the InterQual® CP: Procedures, Electrophysiology (EP) Testing +/- Catheter Ablation, Cardiac clinical criteria and the member's specific benefit plan terms. Coding and benefit applicability statements in the policy reference plan documents and applicable laws.
Applicable Procedure Codes
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.