CurrentCapital BluecrossPolicy MP 8.012

Neural therapy

This policy governs coverage of neural therapy (injections of local anesthetics into scars, trigger points, acupuncture points, peripheral nerves, autonomic ganglia, epidural space and other tissues) for Capital BlueCross products and programs; it declares the procedure investigational for all indications.

Policy Summary

PayerCapital Bluecross

PolicyNeural therapy

Policy CodePolicy MP 8.012

Change TypeNo material changes

Effective DateFeb 1, 2026

Next Review Date

Key ActionDo not bill or expect coverage for neural therapy procedures — services billed as neural therapy are investigational and will be denied.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Investigationalcoverage stance

2026-02-01effective date

MP 8.012identifier

No FDA regulationregulatory status

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.

Neural therapy is separate from routine peripheral nerve blocks or local anesthetic injections used for standard anesthesia or diagnostic/therapeutic nerve blocks. For example, a temporary genicular nerve block for osteoarthritic knee pain would not be considered neural therapy. Neural therapy injections may be given at sites remote from the pain source and can be delivered as a single session or as a series over weeks to months.

Neural therapy is considered investigational for all indications because available evidence is insufficient to demonstrate a consistent benefit on health outcomes. Systematic review of randomized and nonrandomized trials found few high-quality English-language studies and methodological limitations that preclude definitive conclusions on efficacy; relevant outcomes include symptoms, function, quality of life, medication use, and treatment-related morbidity.

Provider Actions and Billing Guidance

Billing Rule

Coding & prior authorization implications

Coding and prior-authorization implications: The procedure codes listed below are used when neural therapy is billed (therapeutic injection CPT codes). Identification of a code here does not imply coverage; prior authorization requirements, if any, are determined by the member's benefit plan. Providers should verify member eligibility and any prior authorization requirements with Capital Blue Cross before billing.

No specific HCPCS codes exist for these local anesthetic injections when billed as neural therapy; report using therapeutic injection CPT codes.
Presence of a CPT code in this section does not denote coverage — coverage is determined by member benefit terms and medical necessity.

Step Therapy

Step therapy

No step therapy requirements specified for neural therapy.

Denial Risk

Coverage and payment determinations

Coverage and payment determinations are subject to the member's benefit plan, eligibility on the date of service, and a finding that the service is medically necessary and appropriate. Final claim payment is based on the member's contract terms, including benefit limitations and exclusions. If there are questions, contact Capital Blue Cross Provider Services or Member Services.

Services billed as neural therapy are considered investigational for all indications and will be denied/not covered.
Prior authorization and medical necessity reviews do not override the investigational determination; claims billed for neural therapy will be processed consistent with this policy and member contract terms.

Coding and Claims

Investigational when used for neural therapy; therefore, not coveredCPTNot Covered

64417	Procedure code listed as investigational when used for neural therapy
64418	Procedure code referenced in coding list
64425	Procedure code referenced in coding list
64430	Procedure code referenced in coding list
64435	Procedure code referenced in coding list
64445	Procedure code referenced in coding list
64446	Procedure code referenced in coding list
64447	Procedure code referenced in coding list
64448	Procedure code referenced in coding list
64449	Procedure code referenced in coding list

1–10 of 24

1/3

Definitions

Neural therapy — definition and scope

DefinitionInjection of a local anesthetic (e.g., procaine or lidocaine) into tissues such as scars, trigger points, acupuncture points, tendon/ligament insertions, peripheral nerves, autonomic ganglia, the epidural space, or other tissues to treat chronic pain or other chronic conditions.

Target tissues/sitesScars; trigger points; acupuncture points (neural acupuncture); tendon and ligament insertions; peripheral nerves; autonomic ganglia; epidural space; other tissues.

Therapeutic rationaleIntended to address 'interference fields' and restore normal resting potential/energy flow by reestablishing electrochemical balance of nerves and tissues.

Typical agents usedLocal anesthetics such as procaine or lidocaine.

Indications noted in policyPromoted mainly to relieve chronic pain; has been proposed for other chronic conditions (e.g., allergies, infertility, tinnitus, depression, chronic bowel problems).

Background

Neural therapy involves injection of local anesthetic agents such as procaine or lidocaine into various tissues — for example, scars, trigger points, acupuncture points, tendon or ligament insertions, peripheral nerves, autonomic ganglia, or the epidural space — with the intent of treating chronic pain or other chronic conditions. The practice is based on concepts such as “interference fields” and restoring nerve resting potential; treatments may be performed at locations distant from the pain and may range from a single injection to multiple sessions over time.

Not Covered — Summary

Neural therapy is investigational and not covered for any indication. When therapeutic injection CPT codes listed in the policy (e.g., the codes used to report therapeutic peripheral nerve or ganglion injections) are billed specifically for neural therapy, those services are considered investigational and will not be covered.