Transcutaneous Electrical Nerve Stimulators (TENS)




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Topic Details
Coverage Criteria

Covered for treatment of beneficiaries with chronic, intractable pain or acute post-operative pain

  • Acute Post-operative Pain - when one of the following coverage criteria are met.
    • Coverage is limited to 30 days (one month’s rental) from the day of the surgery. Payment will be made only as a rental.
    • A TENS unit will be denied as not reasonable and necessary for acute pain (less than three months duration) other that for post-operative pain.
  • Chronic Pain Other than Low Back Pain - when all the following criteria is met:
    • The presumed etiology of the pain must be a type that is accepted as responding to TENS therapy. Examples of conditions for which TENS therapy is not considered to be reasonable and necessary are (not all-inclusive):
      • Headache, Visceral abdominal pain, Pelvic pain, Temporomandibular joint (TMJ) pain
    • The pain must have been present for a least three months
    • Other appropriate treatment modalities must have been tried and failed.
TENS therapy for chronic pain that does not meet these criteria will be denied as not reasonable and necessary.




Last Updated Feb 19 , 2024