WATCHMAN Cost & Coverage
Explore the potential cost and coverage for your patients receiving a WATCHMAN Implant.
WATCHMAN is covered nationally by Centers for Medicare & Medicaid Services (CMS) and most commercial insurers for patients who have a documented clinical need to seek an alternative to OACs.1 Clinical scenarios may include:
Need an alternative to oral anticoagulants (OACs), including those with an occupation-related high bleeding risk or a high risk of recurrent falls.
Have trouble maintaining a stable International Normalized Ratio (INR)
Struggle with treatment compliance
Select CMS coverage criteria
Patients may be covered by insurance for a WATCHMAN LAAC Implant when the following criteria are met, with supporting documentation:
Increased risk for stroke
Suitable for short-term oral anticoagulation
Formal shared decision-making interaction
Estimated Medicare patient out-of-pocket costs for the WATCHMAN Implant
A typical Medicare patient in 2026 will pay no more than $3,318 in out-of-pocket (OOP) costs to receive the WATCHMAN Implant.
Standalone
WATCHMAN Implant
Post-WATCHMAN Therapy
Total max estimated 2026 Medicare patient OOP costs: $3,318
References:
- CMS NCD 20.34: https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=367
- The pre-screen TEE cost will be different if it is completed within 72 hours before hospital admission due to the 3-Day Payment window. Source: CMS MLN Matters, SE20024, December 3, 2020.
- Patient Costs are calculated based on Medicare beneficiaries 20% coinsurance payment for Part B services, for both hospital (where applicable) and physician work. Rates are CY2026 Medicare rates set by the CY2026 CMS Physician Fee Schedule and CY2026 CMS Hospital Outpatient Prospective Payment System Annual Rules. Payments from Optum, Inc. Accessed 01/12/2026.
- Traditional Medicare beneficiaries 2026 Part A ($1,736), ($283) Part B, and ($615) Part D deductibles may have already been met for patients if they have had prior medical services unrelated to WATCHMAN procedures.
- Post-procedure drug prices are sourced from GoodRx.com, using Xarelto and Eliquis. This scenario assumes that a traditional Medicare beneficiary has paid $0 towards their 2026 Medicare Part D deductible ($615) and a 25% copay
Note: Estimated costs are based on national averages of 2026 U.S. Medicare rates, and assume a 20% copay for Medicare Part B. These estimates will vary depending upon the patient’s individual healthcare policy. Insurance coverage can vary significantly from one plan to another, even within the same insurance company. We therefore recommend that patients contact their insurance provider directly with questions regarding estimated patient-specific out-of-pocket costs.
Health economic and reimbursement information provided by Boston Scientific Corporation is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules, and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice. Boston Scientific encourages providers to submit accurate and appropriate claims for services.
It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services, and to submit appropriate codes, charges, and modifiers for services rendered. It is also always the provider’s responsibility to understand and comply with Medicare national coverage determinations (NCD), Medicare local coverage determinations (LCD), and any other coverage requirements established by relevant payers which can be updated frequently. Boston Scientific recommends that you consult with your payers, reimbursement specialists, and/or legal counsel regarding coding, coverage, and reimbursement matters.
Boston Scientific does not promote the use of its products outside their FDA-approved label. Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding, or site of service requirements.
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