CurrentBlue Cross Blue Shield - Rhode IslandPolicy N/A

Subtalar Arthroereisis (Extraosseous Talotarsal Stabilization) Coverage Policy

This policy governs coverage determinations for subtalar arthroereisis (extraosseous talotarsal stabilization/sinus tarsi implant) for BCBSRI members, describing when the procedure is considered medically necessary or not and which procedure codes are not covered.

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicySubtalar Arthroereisis (Extraosseous Talotarsal Stabilization) Coverage Policy

Policy CodePolicy N/A

Change TypeNo material clinical or coverage changes

Effective DateJan 1, 2023

Next Review DateN/A

Key ActionVerify member-specific benefit and prior authorization requirements in the member's benefit documents before submitting claims.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Not coveredCoverage stance for subtalar arthroereisis

2Procedure codes explicitly not covered

LimitedEvidence

ChildrenPopulation concern

Coverage Determination

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.

Not Medically Necessary / Not Covered

Main policy stance: Subtalar arthroereisis is considered not covered/not medically necessary because the evidence is insufficient to determine effects on health outcomes.

Applies to Commercial Products and Medicare Advantage as stated.

Rationale - evidence limitations: Evidence consists mainly of single-arm case series and a small nonrandomized comparative trial; available studies are limited by adjunctive procedures that confound attribution of outcomes to the implant procedure alone.

These limitations reduce certainty about effectiveness and safety.

Rationale - pediatric and long-term outcome concerns: Published data lack long-term outcomes, which is particularly important because the procedure is often performed in growing children.

Long-term effectiveness and durability are uncertain.

Rationale - safety concerns: Some studies have reported high rates of complications and implant removal, further limiting confidence in net health benefit.

Adverse event and reoperation risks contribute to the determination of not medically necessary.

Rationale: Subtalar arthroereisis (extraosseous talotarsal stabilization) is designated as not covered / not medically necessary because the available evidence is insufficient to determine its effects on health outcomes. The literature is dominated by single‑arm case series and a very small nonrandomized comparative trial, and many reports include adjunctive procedures that confound interpretation of the procedure’s independent benefit.

The following procedure codes are not covered for Medicare Advantage Plans and Commercial Products: 0335T (Insertion of sinus tarsi implant) and S2117 (Arthroereisis, subtalar).

Provider Next Steps and Billing Impact

Prior Authorization

Prior authorization is not applicable for this policy. However, prior authorization requirements may vary by member plan — verify benefits for each member.

Prior authorization: Not required per policy — verify member plan for exceptions.

Note

Benefit Verification Recommended

Benefits vary by contract. Providers should verify member-specific coverage by consulting the member's Benefit Booklet, Evidence of Coverage, or Subscriber Agreement before scheduling services.

Check member's Benefit Booklet / Evidence of Coverage / Subscriber Agreement for coverage details.

Denial Risk

Denial Risk for Procedure

Subtalar arthroereisis is considered not covered under this policy. Claims for this procedure may be denied as not covered or not medically necessary.

Procedure considered not covered — denial risk for payment.

Documentation Required

Provider Action: Verify Benefits and Member Requirements

Providers should verify benefits and any member-specific requirements prior to providing services and submitting claims. When in doubt, obtain pre-service confirmation from the payer using the member's contract documents.

Verify benefits and any prior authorization or medical necessity requirements per member contract.
Obtain pre-service confirmation from Blue Cross Blue Shield - Rhode Island when coverage is unclear.

Background

Subtalar arthroereisis (also called extraosseous talotarsal stabilization) involves placement of an implant in the sinus tarsi between the talus and calcaneus. The implant is intended to limit talar displacement and calcaneal eversion, thereby reducing excessive pronation across the subtalar joint and stabilizing the talotarsal articulation. Clinical reports describe use for flexible flatfoot and talotarsal joint dislocation, often in growing children, with outcomes reported for symptoms and function but with limited long‑term data and documented rates of complications and implant removal.

Definitions

Subtalar arthroereisis — definition

Procedure nameSubtalar arthroereisis (extraosseous talotarsal stabilization)

DefinitionPlacement of an implant in the sinus tarsi (canal between the talus and calcaneus) to reduce pronation across the subtalar joint and correct excessive talar displacement and calcaneal eversion.

Anatomic targetSinus tarsi between the talus and calcaneus

Therapeutic intentLimit movement across the subtalar joint to correct flatfoot/excessive pronation and treat talotarsal joint dislocation.

Alternative termExtraosseous talotarsal stabilization