Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PNT) Policy
Policy governing coverage determinations for PENS and PNT for chronic pain across Blue Cross & Blue Shield of Rhode Island products, with separate stances for BlueCHiP for Medicare and Commercial products, coding guidance, and prior authorization information.
No material changes
Coverage Summary & Medical Necessity
This policy governs coverage determinations for Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PNT) for chronic pain across Blue Cross & Blue Shield of Rhode Island products. Effective date: 10/02/2018; Last review: 10/02/2018. Coverage stance is mixed: for BlueCHiP for Medicare PENS/PNT are covered with specific medical necessity criteria, whereas for Commercial products PENS/PNT are considered not medically necessary because the evidence is insufficient to determine effects on health outcomes.