Local Coverage Determination Release for Notice - Transcutaneous Electrical Nerve Stimulators (TENS)

Joint DME MAC Publication
Posted October 7, 2021

The Centers for Medicare and Medicaid Services (CMS) assigned to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) the task of developing Local Coverage Determinations (LCDs) for Durable Medical Equipment, Prostheses, Orthoses, and Supplies (DMEPOS). The DME MACs are publishing the Transcutaneous Electrical Nerve Stimulators (TENS) LCD (L33802) for notice due to a non-discretionary change in the CMS National Coverage Determination 160.27 - Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low Back Pain (CLBP). See CMS National Coverage Determination Manual (CMS Pub. 100-03), Part 1, Section 160.27. This revised LCD is effective for claims with dates of service on or after November 20, 2021.

Rationale for Change: In accordance with NCD 160.27, coverage of TENS for CLBP is no longer available under Coverage with Evidence Development. Per NCD 160.27, TENS is not reasonable and necessary for the treatment of CLBP under section 1862(a)(1)(A) of the Act. As a result, the DME MACs are removing this requirement as a non-discretionary change to the LCD, per the CMS Program Integrity Manual (CMS Pub. 100-08), Chapter 13, Section 13.2.4.

Refer to each DME MAC web site for additional information, including access to the revised LCD.

Thank you for your interest in our policy development process.

Smitha M. Ballyamanda, MD, CAQSM
Medical Director, DME MAC, Jurisdiction A
Noridian Healthcare Solutions, LLC

Stacey V. Brennan, MD, FAAFP
Medical Director, DME MAC, Jurisdiction B
CGS Administrators, LLC

Robert D. Hoover, Jr., MD, MPH, FACP
Medical Director, DME MAC, Jurisdiction C
CGS Administrators, LLC

Peter J. Gurk, MD, CPE, CHCQM
Medical Director, DME MAC, Jurisdiction D
Noridian Healthcare Solutions, LLC

 

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