Supplies Used With Functional Electrical Stimulators (FES) - E0770

Original Effective Date: 06/23/2011           
Revision Effective Date: 11/01/2013

Electrodes used with a covered E0770 (FUNCTIONAL ELECTRICAL STIMULATOR, TRANSCUTANEOUS STIMULATION OF NERVE AND/OR MUSCLE GROUPS, ANY TYPE, COMPLETE SYSTEM, NOT OTHERWISE SPECIFIED) are eligible for reimbursement as long as the E0770 device meets the coverage criteria outlined in the CMS National Coverage Determination and are used by the patient. Functional electrical stimulators are a type of neuromuscular stimulator (NMES), therefore supply codes used with NMES devices are to be used with FES devices. Electrodes are billed with code:

  • A4595 is an allowance for all necessary supplies used during the month regardless of the number of lead/electrode changes made. All necessary supplies such as electrodes, coupling gel, adhesive, adhesive remover, etc. are considered as included in the monthly allowance. If two FES leads/electrodes are required then a maximum of one unit of Code A4595 would be allowed per month; if four FES leads/electrodes are necessary, a maximum of two units per month would be allowed.

There is no separate payment for supplies provided with an initial claim. Initial provision of an E0770 includes all necessary supplies. Separate billing of supplies with the initial claim is considered unbundling.

For additional information about the coverage of FES and supplies, refer to CMS IOM Pub. 100-03 National Coverage Determination (NCD) Manual, section 160.12.

Last Updated May 11 , 2017