What to know about insurance coverage

Where do you get your health insurance coverage?

• I have original Medicare
• I have a Medicare Advantage plan, Tricare, or Medicaid
• I have health insurance through my job and/or my spouse’s job
• I have other health insurance (self-purchased, Marketplace, etc.)

Medicare coverage of the Symplicity™ blood pressure procedure¹

The Symplicity™ blood pressure procedure is now covered by Medicare for patients who meet certain requirements. If you have a diagnosis of uncontrolled high blood pressure^† (also called hypertension), your Symplicity™ procedure could be covered by Medicare. Talk with your doctor to determine if you are eligible.

To qualify, you must:

• Have uncontrolled high blood pressure that is above or equal to 140/90 mmHg, as confirmed by special monitoring^†
• Consistently try prescribed medications as tolerated and try doctor-recommended lifestyle changes to manage your blood pressure for at least six weeks
• Be evaluated by your doctor for other causes of high blood pressure, also known as secondary hypertension
• See a doctor for your high blood pressure three or more times over at least a six-month period, including a minimum of one in-person visit

Note: The procedure will not be covered if you have previously had a renal denervation procedure or have certain medical conditions affecting the kidneys or renal arteries.

The Symplicity™ BPP is contraindicated in patients:

• Who are pregnant
• Who have renal artery fibromuscular dysplasia (FMD) causing narrowing of the arteries
• With a bulging or weakened area in the kidney
• With renal artery diameter narrowing caused by plaque build up > 50%
• With an abnormal kidney tumor
• Who have had a renal stent placed less than 3 months prior to the procedure
• With renal artery diameter < 3 mm or > 8 mm

For full details, visit the Centers for Medicare & Medicaid Services (CMS) website here.

Private insurance coverage for the Symplicity™ blood pressure procedure (including self-purchased, employer provided, and Medicare Advantage plans)

The Symplicity™ blood pressure procedure is an innovative treatment, and coverage policies are still evolving. Coverage can vary depending on your insurance plan, so it’s a good idea to check with your insurance company to understand what’s covered. When speaking with them, you need to reference the procedure as renal denervation, which is the technical name used for coding and coverage purposes.

Before scheduling the procedure

Your doctor may need to get preapproval from your insurance company before you can have the Symplicity™ procedure. This is called prior authorization. Your insurance company will review its policies and information from your doctor to determine if the procedure will be covered. This process can take a couple of weeks, and does not require any action from you besides confirming that your doctor has your current insurance information. Not all insurance plans require preapproval for the procedure, so check with your provider.

Appealing to your insurance company

If your insurance company denies coverage for the Symplicity™ blood pressure procedure, you’re not out of options. Many insurance companies allow you to file an appeal, which is a request for them to reconsider their decision. It can be submitted by you or your doctor. The appeal process can take time (sometimes 30 days or more), and the steps may vary depending on your insurance plan. If you receive a denial, check the denial letter for specific instructions on how to appeal the decision. If you are considering an appeal for the Symplicity™ procedure or would like to support your doctor’s appeal, you may find the following resource helpful:

Questions?

If you have questions on the preapproval or appeal process, or to check the status of a request, please contact your insurance company using the number on your insurance card.
 

† Uncontrolled high blood pressure must be diagnosed one of two ways:

• By a prescribed series of blood pressure readings that you take at home with your own blood pressure cuff
• By ambulatory blood pressure monitoring
  • This test involves wearing a blood pressure cuff around your arm to record dozens of blood pressure readings over a 24-hour period. Your doctor then uses the results to calculate your average blood pressure.

1. Centers for Medicare & Medicaid Services. Renal denervation for uncontrolled hypertension: Final decision memo. Updated October 28, 2025. Accessed October 28, 2025.