CurrentBlue Cross Blue Shield - Rhode IslandPolicy N/A

Autonomic nervous system (ANS) testing — portable automated devices

Policy governing coverage of portable automated autonomic nervous system testing devices for Commercial products of Blue Cross Blue Shield - Rhode Island; affects providers seeking reimbursement for ANS testing using portable/automated devices. BlueCHiP for Medicare addressed separately.

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyAutonomic nervous system (ANS) testing — portable automated devices

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionClaims for autonomic nervous system testing using portable automated devices will be considered not medically necessary for all indications and are subject to denial.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

All indicationsNot medically necessary

95943Covered code (not reimbursed)

CommercialApplies to

RequiredDedicated lab required

Coverage Determinations

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Overall coverage stance

Covered when ALL of the following are met:

Main coverage rules: Portable automated autonomic nervous system testing devices are considered not medically necessary for all indications; testing should be performed in a dedicated ANS testing laboratory with expert interpretation; non-standardized component information determined by a physician is included in the physician's basic E/M and is not separately reimbursed.

CPT 95943 is listed as a covered service but providers will not be separately reimbursed for this service.

Portable automated autonomic nervous system (ANS) testing devices are excluded as not medically necessary for all indications. The evidence is insufficient to determine that these technologies improve health outcomes, and claims for ANS testing performed using portable automated devices will be denied.

The determination that portable automated ANS testing devices are not medically necessary is based on insufficient evidence that results from these devices affect clinical outcomes. In addition, non‑standardized autonomic function information that a physician deems useful for patient assessment is considered part of the physician’s basic evaluation and management service and is not separately reimbursed.

Coding and Billing

Covered CPT Codes (not separately reimbursed)CPTCovered

95943

Simultaneous, independent, quantitative measures of both parasympathetic function and sympathetic function, based on time frequency analysis of heart rate variability concurrent with time-frequency analysis of continuous respiratory activity, with mean heart rate and blood pressure measures, during rest, (deep) breathing; Valsalva maneuvers, and head-up postural change paced

What Providers Need To Do

Prior Authorization

Prior authorization

Not applicable

Documentation Required

Provider actions — general

Providers should document the clinical rationale for autonomic nervous system (ANS) testing in the medical record. Non‑standardized components of autonomic function testing that a physician determines are useful for patient assessment are considered part of the physician's evaluation and management and are not separately reimbursed.

Note

Dedicated laboratory and expert interpretation required

ANS testing should be performed in a dedicated ANS testing laboratory under closely controlled conditions, and results should be interpreted by an individual with expertise in ANS testing. Automated or portable devices with results interpreted solely by computer software have not been validated and may lead to erroneous results; expert interpretation is required.

Billing Rule

Billing guidance — portable automated devices not medically necessary

Portable automated ANS testing devices are considered not medically necessary for all indications; claims for portable automated ANS testing should be denied as not medically necessary. Use documentation to support that any autonomic function assessment beyond the physician's basic evaluation is performed in an appropriate dedicated laboratory with expert interpretation.

Background

The autonomic nervous system regulates physiologic functions not under conscious control (for example, cardiac, respiratory, gastrointestinal motility, thermoregulation, bladder and sexual function). Autonomic nervous system testing is a battery of individual tests intended as an adjunct to the clinical examination. Per policy, testing should be performed and interpreted in an appropriate, dedicated setting by clinicians with expertise in ANS testing; automated portable device testing and standalone automated interpretation have not been shown to provide validated, outcome‑changing information.

Definitions

Autonomic nervous system (ANS) testing — key definition

DefinitionBattery of individual tests evaluating integrity and function of the sympathetic and parasympathetic systems as adjuncts to the clinical examination.

Physiologic domains assessedCardiac (heart rate), respiratory, gastrointestinal motility, thermoregulation, bladder and sexual function.

Testing environment requirementTesting should be performed in a dedicated ANS testing laboratory under closely controlled conditions.

Interpretation requirementResults should be interpreted by an individual with expertise in ANS testing; automated device–only interpretation has not been validated.

CPT 95943 — definition/description

CPT Code95943

DescriptionSimultaneous, independent, quantitative measures of both parasympathetic function and sympathetic function, based on time-frequency analysis of heart rate variability concurrent with time-frequency analysis of continuous respiratory activity, with mean heart rate and blood pressure measures, during rest, deep breathing, Valsalva maneuvers, and head-up postural change.

Reimbursement noteListed as a covered service for Commercial Products but providers will not be separately reimbursed for this service.