CurrentPremera BluecrossPolicy 7.01.588

Percutaneous Electrical Nerve Stimulationand Percutaneous Neuromodulation Therapy

Defines Premera Bluecross coverage position for percutaneous electrical neurostimulation (PENS) and percutaneous neuromodulation therapy (PNT) for chronic pain conditions, summarizes evidence, coding guidance, related guidance and Medicare NCD applicability. Applies to commercial lines (not Medicare Advantage).

Policy Summary

PayerPremera Bluecross

PolicyPercutaneous Electrical Nerve Stimulationand Percutaneous Neuromodulation Therapy

Policy CodePolicy 7.01.588

Change TypeAnnual review; statements unchanged

Effective DateJun 1, 2026

Next Review Date

Key ActionReport PENS/PNT using unlisted nervous system CPT code 64999 and do not use CPT codes 64553, 64555, 64561 or 64590 for these procedures.

SourceLink

POLICY UPDATE CHANGES

Policy renumbered from 7.01.29 to 7.01.588 on 10/01/23; annual reviews through 01/22/2026 with policy statements unchanged.

2Procedures designated investigational

1Unlisted CPT code allowed

4CPT codes noted as inappropriate to bill

Coverage Summary & Determination

Defines Premera Blue Cross coverage position for Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PNT) for chronic pain conditions. Both procedures are designated investigational and therefore not covered for the treatment of chronic pain in the commercial lines population. This policy applies to commercial lines (does not apply to Medicare Advantage).