CurrentRegencePolicy M-DME83

Electrical Stimulation and Electromagnetic Therapy Devices

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This Medicare Advantage policy governs coverage and medical-necessity review for electrical stimulation, electromagnetic therapy, and related devices used for pain, neurologic conditions, muscle atrophy, ambulation, wound treatment, and other indications. Coverage depends on applicable CMS guidance, Medicare Advantage criteria, the member Evidence of Coverage, and any applicable prior-authorization requirements.

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CurrentRegencePolicy M-DME83

Electrical Stimulation and Electromagnetic Therapy Devices

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Policy Summary

PayerRegence

PolicyElectrical Stimulation and Electromagnetic Therapy Devices

Policy CodePolicy M-DME83

Change TypeNo material change

Effective Date07/01/2026

Last ReviewJun 1, 2026

Next Review Date08/01/2026

Key ActionConsult Regence's Medicare Pre-authorization List before rendering electrical stimulation or electromagnetic services or providing related devices.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

10+Device or service categories addressed

270.1CMS wound-stimulation coverage determination

Pain onlyTENS coverage limitation

3Required documentation categories

2Noncovered Medicare Status N codes

Coverage Criteria

General medical-necessity standard

Electrical stimulation devices may be considered medically necessary when all of the following are met:

General electrical stimulation coverage: The requested equipment corresponds to an HCPCS code eligible for Medicare coverage, applicable Medicare or plan coverage criteria are met, and the service or item is medically reasonable and necessary.

S-codes are not payable by Medicare and therefore are not eligible for coverage under this policy guidance.

Electrical or electromagnetic therapy for wounds

Wound electrical or electromagnetic stimulation is governed by CMS NCD 270.1 and requires all of the following:

Wound-treatment criteria: The wound type and stage, attempted standard wound therapy, and whether measurable signs of improved healing are present must be documented; applicable Medicare wound-stimulation criteria must also be met.

Medicare may cover the wound-treatment service but not the device used for electrical stimulation. Unsupervised home use of electrical or electromagnetic wound therapy is not covered.

Pain-related stimulation

TENS and related stimulation devices may be considered medically necessary when all of the following are met:

TENS or IFC/IFS for pain: The device is used for a pain-related indication and the applicable Medicare coverage criteria for the device are met.

If the device is provided as an NMES/FES device, report E0745 and apply the applicable FES/NMES criteria.

COMS study coverage

Concurrent optical and magnetic stimulation for wounds may be covered when all of the following are met:

COMS Category B IDE study: The member is participating in the Medicare-approved Category B Investigational Device Exemption study for the COMS One Therapy System.

Coverage guidance is unavailable for recipients who are not participating in the Medicare-approved Category B study.

Specified chronic ulcer indications

G0281 and G0329 apply when all of the following are met:

Qualifying chronic ulcer: The condition is a chronic stage III or stage IV pressure ulcer, arterial ulcer, diabetic ulcer, or venous stasis ulcer.Stage III or IV chronic ulcer or specified arterial, diabetic, or venous stasis ulcer

Failure of conventional care: The ulcer has not demonstrated measurable signs of healing after 30 days of conventional care.No measurable healing after 30 days of conventional care

Therapy plan of care: The electrical stimulation or electromagnetic therapy is provided as part of a therapy plan of care.

Applies to electrical stimulation billed with G0281 and electromagnetic therapy billed with G0329.

E0762 product eligibility

Billing under HCPCS E0762 requires both of the following:

Verified transcutaneous electrical joint stimulation product: The product has undergone Coding Verification Review by the SADMERC.SADMERC Coding Verification Review

DMECS product listing: The product is listed in the DMECS Product Classification List on the SADMERC website.Listed in the DMECS Product Classification List

Investigational or experimental services, cosmetic services, and items or services that are not medically reasonable and necessary under Social Security Act §1862(a)(1)(A) are excluded from coverage. Applicable member benefit and Medicare requirements continue to apply.

The device used to provide electrical or electromagnetic stimulation for wound treatment is not covered, although the wound-treatment service may be covered when applicable criteria are met. Unsupervised home use of electrical or electromagnetic wound therapy is also not covered.

TENS devices used for indications other than pain are non-covered. This includes use for attention deficit hyperactivity disorder (ADHD), which does not meet Medicare’s medically reasonable and necessary criteria.

Electrical stimulation for wound healing is considered an off-label indication because no electrical stimulation device has received U.S. Food and Drug Administration approval specifically for wound healing. Devices cleared for other indications do not thereby receive FDA approval for wound healing.

Electrical stimulation for wound care other than the qualifying G0281 indication, and electromagnetic therapy for wound care other than the qualifying G0329 indication or for other uses, is excluded from Medicare coverage. These noncovered wound-care services include G0282 and G0295.

Medicare coverage for TENS devices is limited to pain-related indications. Use for other indications, including ADHD, does not meet Medicare’s medically reasonable and necessary criteria and is non-covered.

Medical Necessity Requirements

General DME criteria

DME may be considered medically necessary when all of the following are met:

DME medical necessity: The requested equipment corresponds to an eligible Medicare code, applicable CMS or plan coverage criteria are satisfied, and the equipment is medically reasonable and necessary.

Providers remain responsible for correct coding, billing, and medical necessity. S-codes are not payable by Medicare and are not eligible under the stated policy guidance.

Chronic ulcer wound therapy

Specified wound-treatment electrical or electromagnetic therapy requires all of the following:

Qualifying chronic ulcer: The patient has a chronic stage III or stage IV pressure ulcer, arterial ulcer, diabetic ulcer, or venous stasis ulcer.Stage III or IV chronic ulcer or specified arterial, diabetic, or venous stasis ulcer

Coding and Billing

Galvanic StimulationHCPCS

E1399

Galvanic Stimulation

H-wave StimulationHCPCS

E1399

H-wave Stimulation

Microcurrent Stimulation (MENS)HCPCS

E1399

Microcurrent Stimulation (MENS)

Functional Neuromuscular Electrical StimulationHCPCS

A4560	Functional Neuromuscular Electrical Stimulation
E0731	Functional Neuromuscular Electrical Stimulation
E0744	Functional Neuromuscular Electrical Stimulation
E0745	Functional Neuromuscular Electrical Stimulation
E0764	Functional Neuromuscular Electrical Stimulation
E0770	Functional Neuromuscular Electrical Stimulation

StimulationHCPCS

K1019

Stimulation

Electrostimulation Therapy (CES)HCPCS

E1399	Electrostimulation Therapy (CES)
K1002	Electrostimulation Therapy (CES)

Electrostimulation and Electromagnetic Therapy for WoundsHCPCSCovered

E0769	Electrostimulation and Electromagnetic Therapy for Wounds
G0281	Electrostimulation and Electromagnetic Therapy for Wounds
G0282	Electrostimulation and Electromagnetic Therapy for Wounds
G0295	Electrostimulation and Electromagnetic Therapy for Wounds

Electromagnetic Stimulation Therapy for WoundsCPT

0907T

Electromagnetic Stimulation Therapy for Wounds

Electrical Stimulation for Peripheral Nerve RegenerationCPT

0882T	Electrical Stimulation for Peripheral Nerve Regeneration
0883T	Electrical Stimulation for Peripheral Nerve Regeneration

Electrical Stimulation and Electromagnetic DeviceHCPCS

E0762

Electrical Stimulation and Electromagnetic Device

Transcutaneous Electrical Modulation Pain Reprocessing (TEMPR)mixed

0278T	Transcutaneous Electrical Modulation Pain Reprocessing (TEMPR)
K1023	Transcutaneous Electrical Modulation Pain Reprocessing (TEMPR)

Non-Implantable (External) Trigeminal Nerve Stimulation (eTNS)HCPCS

K1016	Non-Implantable (External) Trigeminal Nerve Stimulation (eTNS)
K1017	Non-Implantable (External) Trigeminal Nerve Stimulation (eTNS)

Electrical Stimulation for Essential Tremormixed

E0734	Electrical Stimulation for Essential Tremor
A4542	Electrical Stimulation for Essential Tremor

Electrical Stimulation Devices Not Included Within the Scope of This PolicyHCPCS

E1399

Electrical stimulation devices not otherwise addressed in this or another Medicare Advantage policy

Stimulation (TENS) for Pain / Interferential Current Stimulation (IFC or IFS)HCPCSCovered

E0731	Electrical Stimulation Device
E0730	Electrical Stimulation Device
E0745	Electrical Stimulation Device
E1399	Electrical Stimulation Device
S8130	Electrical Stimulation Device
S8131	Electrical Stimulation Device

CPT CodesCPT

0278T	Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes).
0766T	Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and marking of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve.
0767T	Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and marking of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (List separately in addition to code for primary procedure).
0882T	Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, minimum of 10 minutes; initial nerve (List separately in addition to code for primary procedure).
0883T	Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, minimum of 10 minutes; each additional nerve (List separately in addition to code for primary procedure).
0906T	Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm.
0907T	Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (List separately in addition to code for primary procedure).

HCPCS CodesHCPCS

A4540

Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm

DME HCPCS CodesHCPCS

A4541	Monthly supplies for use of device coded at E0733.
A4542	Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist.
A4544	Electrode for external lower extremity nerve stimulator for restless legs syndrome.
A4560	Neuromuscular electrical stimulator (NMES), disposable, replacement only.
A4596	Cranial electrotherapy stimulation (CES) system supplies and accessories, per month.
E0490	Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote.
E0491	Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply.
E0492	Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application.
E0493	Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply.
E0731	Form fitting conductive garment for delivery of TENS or NMES (with conductive fibers separated from the patient's skin by layers of fabric).

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Covered Wound Treatment CodesHCPCSCovered

G0281	Electrical stimulation, (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care.
G0329	Electromagnetic therapy, to one or more areas for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care.

Not Covered Wound Treatment CodesHCPCSNot Covered

G0282	Electrical stimulation, (unattended), to one or more areas, for wound care other than described in G0281 (Non-covered by Medicare).
G0295	Electromagnetic stimulation, to one or more areas, for wound care other than described in G0329 or for other uses (Non-covered by Medicare)

Conventional care before specified chronic ulcer stimulation

Required conventional care30 days

Healing statusNo measurable signs of healing during the 30-day period

Applicable therapyElectrical stimulation billed with G0281 or electromagnetic therapy billed with G0329

Provider Actions and Coverage Checks

Prior Authorization

Check the Medicare Pre-authorization List

Check the Medicare Pre-authorization List before scheduling electrical stimulation or electromagnetic devices and procedures. Some services may be reviewed externally by a vendor.

Billing Rule

Codes Not Listed for Prior Authorization

Specific electrostimulation and electromagnetic codes that are not listed on the Medicare Pre-authorization List do not require prior approval. Providers remain responsible for correct coding, billing, and medical necessity.

Required Documentation

Documentation Required

Document the clinical condition and symptoms

Submit pertinent chart notes and medical records, including history and physical documentation of the condition being treated and the symptoms experienced.

Documentation Required

Specify the therapy and equipment

Identify the type of planned electrical stimulation and the device name.

Documentation Required

Provide wound-specific medical-necessity documentation

For wound treatment, include the wound type and stage, attempted standard wound therapy, and whether measurable signs of improved healing exist.

Documentation Required

Background

This policy addresses electrical stimulation and electromagnetic therapy devices and services used for pain, neurologic conditions, muscle stimulation and ambulation, wound treatment, arthritis-related symptoms, peripheral nerve regeneration, essential tremor, trigeminal nerve stimulation, and related indications. Coverage depends on applicable Medicare or plan criteria, medical necessity, coding requirements, and any required authorization.

Therapy and Device Definitions

Galvanic stimulation

Current typeUnidirectional electrical current

Delivery methodDelivered between two electrodes placed on the skin

Proposed usesInflammation, pain, nausea, edema, and wound healing

H-wave stimulation

WaveformBipolar, exponentially decaying waveform combining low- and high-frequency wavelengths

Physiologic effectCreates muscle contractions

Proposed usesMuscle stimulation and analgesic pain control

Replacement Guidance

Monarch external Trigeminal Nerve Stimulation System replacement

Replacement statusPeriodic replacement of components is required

Example componentMonarch NS-2 Electric Patch Pouch

Specific intervalNot stated

Not Covered

The following are not covered: devices used for electrical or electromagnetic wound stimulation when the requested item is the device rather than the service; unsupervised home electrical or electromagnetic wound therapy; TENS for indications other than pain, including ADHD; wound-healing use as an FDA-approved indication; electrical wound care other than the qualifying G0281 indication; and electromagnetic wound care other than the qualifying G0329 indication or for other uses, including services billed with G0282 or G0295.

Policy Summary

PayerRegence

PolicyElectrical Stimulation and Electromagnetic Therapy Devices

Policy CodePolicy M-DME83

Change TypeNo material change

Effective Date07/01/2026

Last ReviewJun 1, 2026

Next Review Date08/01/2026

Key ActionConsult Regence's Medicare Pre-authorization List before rendering electrical stimulation or electromagnetic services or providing related devices.

SourceLink

On This Page

Failure of conventional care: The ulcer has not demonstrated measurable signs of healing after 30 days of conventional care.30 days without measurable signs of healing

Therapy plan of care: The stimulation or electromagnetic therapy is provided as part of a therapy plan of care.Documented therapy plan of care

Applies to G0281 and G0329.

COMS wound treatment area

Maximum treatment areaLess than or equal to 50 sq cm

Applicable therapyConcurrent optical and magnetic stimulation (COMS) therapy

Related codes0906T and 0907T

Documentation Required

Submit Required Information for Review

Submit the information below for review to determine whether policy criteria are met. Missing information may affect the review and decision outcome.

All pertinent chart notes and medical records, including history and physical documentation of the condition being treated and symptoms experienced.
The type of planned electrical stimulation and device name.
For wound treatment, the wound type and stage, attempted standard wound therapy, and whether measurable signs of improved healing exist.

Prior Authorization

Check the Medicare Pre-authorization List

Check the Medicare Pre-authorization List for electrical stimulation or electromagnetic devices and procedures that require prior authorization. Codes not listed on the website do not require prior approval.

Documentation Required

Clinical Records

Provide all clinical records pertinent to the request so the plan can evaluate the condition being treated and the symptoms experienced.

Include chart notes, medical records, and a history and physical.
Document the diagnosis, clinical findings, and symptoms relevant to the requested therapy.

Documentation Required

Device and Therapy Identification

Identify the planned electrical stimulation therapy and the specific device being requested.

State the type of electrical stimulation.
Include the device name.

Documentation Required

Wound-Treatment Documentation

For wound treatment requests, submit documentation needed to evaluate Medicare NCD 270.1 criteria.

Type and stage of the wound.
Standard wound therapies that have been attempted.
Whether measurable signs of improved healing are present.

Documentation Required

Clinical Records

Provide all clinical records pertinent to the request, including documentation of the condition being treated and the symptoms experienced.

Submit relevant chart notes and medical records.
Include a history and physical.

Documentation Required

Device and Therapy Identification

Clearly identify the proposed electrical stimulation therapy and device for review.

Specify the type of planned electrical stimulation.
Provide the device name.

Documentation Required

Additional Wound-Treatment Documentation

When electrical stimulation is used for wound treatment, include complete wound and treatment-history documentation.

Document the type and stage of the wound.
Describe attempted standard wound therapy.
State whether measurable signs of improved healing exist.

Documentation Required

Chronic Ulcer Therapy Documentation

For code G0281, document that the ulcer is chronic, stage III or IV, and has not demonstrated measurable signs of healing after 30 days of conventional care as part of a therapy plan of care.

Applicable ulcers include pressure, arterial, diabetic, and venous stasis ulcers.
Document the 30-day trial of conventional care and lack of measurable healing.

Billing Rule

E0762 Coding Documentation

Use HCPCS E0762 only for a transcutaneous electrical joint stimulation device system whose coding has been verified by the SADMERC.

The product must have undergone Coding Verification Review by the SADMERC.
The product must be listed in the DMECS Product Classification List on the SADMERC website.

Billing Rule

E0770 Product Documentation

HCPCS E0770 describes a complete functional electrical stimulator system for transcutaneous stimulation of nerve or muscle groups. Confirm that the product matches the code before billing.

Products identified with E0770 include WalkAide (Innovative Neurotronics), Odstock ODFS Pace FES System (Odstock Medical/Boston Brace), and NESS L300 and H200 devices (Bioness).
Manufacturers of products billed with E0770 must have the code(s) verified by the Medicare PDAC.

Denial Risk

Non-covered Indications and Incomplete Documentation

Do not submit services for non-covered indications, and provide complete documentation supporting medical necessity. Medicare and the member Evidence of Coverage govern when they conflict with this policy.

Unsupervised home use of electrical stimulation or electromagnetic therapy for wound treatment is not covered.
TENS devices used for indications other than pain, including ADHD, are non-covered.
Medicare Status N codes G0282 and G0295 are noncovered by Medicare and Medicare Advantage.
Missing clinical records, therapy identification, or wound documentation may affect the review and decision outcome.

Prior Authorization

COMS Study Participation

For recipients of the COMS One Therapy System, submit the service only when the member is participating in the Medicare-approved Category B Investigational Device Exemption study.

Coverage may be available only for members enrolled in the Medicare-approved Category B study.
For members not participating in the study, Medicare coverage guidance is not available for concurrent optical and electromagnetic stimulation for wound treatment.

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Unsupported block type: denial_risk״

Billing Rule

E0762 Product Verification Requirement

Before billing E0762, verify that the product has completed the required SADMERC Coding Verification Review and appears in the DMECS Product Classification List.

E0762 is used for a transcutaneous electrical joint stimulation device system.
Products without the required coding verification and DMECS listing should not be billed using E0762.

Billing Rule

E0770 PDAC Verification Requirement

Manufacturers of products billed with E0770 must have the code(s) verified by the Medicare PDAC before the product is reported with that HCPCS code.

E0770 is a complete functional electrical stimulator system for transcutaneous stimulation of nerve or muscle groups.
Verify the product and PDAC coding before billing.

Document the planned device and stimulation type

The request must identify the type of planned electrical stimulation and the device name.

Documentation Required

Provide wound-specific clinical documentation

For wound treatment, include the wound type and stage, attempted standard wound therapy, and whether measurable improvement in healing exists.

Billing Rule

Verify the E0762 product

The product billed under E0762 must have undergone Coding Verification Review by the SADMERC and must be listed in the DMECS Product Classification List.

Billing Rule

Verify the E0770 product through the PDAC

Manufacturers of products billed with E0770 must have the code or codes verified by the Medicare PDAC.

Documentation Required

Document chronic ulcer medical necessity

For G0281 and G0329, document the qualifying ulcer type, lack of measurable healing after 30 days of conventional care, and that treatment is provided as part of a therapy plan of care.

Microcurrent stimulation (MENS)

Current intensityTiny, subsensory currents

Device typeMicrocurrent electrical neuromuscular or nerve stimulation device

Proposed usesDecrease pain and facilitate the healing process

Functional neuromuscular electrical stimulation

Stimulation methodSurface electrical impulses activate paralyzed or weak muscles in a precise sequence

Primary application describedEnhance the ability to walk in spinal cord injury patients

Alternative namesNMES, FNS, FES, ENS, or EMG-triggered neuromuscular stimulation

External lower-extremity nerve stimulation

Nerves treatedCommon peroneal nerves near the fibula in the lower legs

Stimulation patternBilateral high-frequency electrical stimulation

Intended effectActivates the tibialis anterior and produces sustained, low-level contractions that mimic voluntary leg movements

Threshold electrical stimulation

IntensityLow-intensity electrical stimulation

Timing and settingDelivered to target spastic muscles during sleep at home

Muscle contractionThe stimulation is not intended to cause muscle contraction

Cranial electrostimulation therapy (CES)

Stimulation locationAcross the head

Electrode placementUsually on or near both ears

Alternative nameCranial electrotherapy stimulation

Electrostimulation and electromagnetic therapy for wounds

Electrical therapyElectrical current is applied through electrodes on the skin in close proximity to the wound

Electromagnetic therapyA pulsed magnetic field is used to induce current

Proposed applicationAccelerating wound healing

Concurrent optical and magnetic stimulation (COMS)

Therapy typeConcurrent optical and electromagnetic stimulation for wounds

Device exampleCOMS One Therapy System by Piomic

Regulatory and coverage statusReceived FDA investigational device exemption in 2022 and Medicare Category B coverage for an ongoing IDE clinical trial

Electrical stimulation for arthritis

Device typeNoninvasive device-delivered electrical stimulation

Treatment targetA joint affected by arthritis

Intended effectReduce pain and symptoms associated with arthritis

Sympathetic electrical stimulation therapy

Nerves treatedPeripheral nerves

Intended nervous-system effectStimulate the sympathetic nervous system in an effort to normalize the autonomic nervous system

Pain targetDesigned to induce a systemic effect on sympathetically induced pain rather than treat only local pain

Interferential current stimulation (IFC or IFS)

Therapy typeTranscutaneous electrical stimulation (TENS)

Proposed tissue effectBelieved to permeate tissues more effectively with less unwanted cutaneous-nerve stimulation than TENS

Primary investigationPain reduction

Transcutaneous electrical modulation pain reprocessing (TEMPR)

Treatment formatA sequence of electrical stimulation treatments in the office setting

SupervisionAdministered under physician supervision

Alternative nameScrambler Therapy

Non-implantable trigeminal nerve stimulation

Device typeNon-implantable device delivering low-level electrical pulses through a forehead patch during sleep

Stimulation targetBranches of the trigeminal nerve

Monarch pediatric use describedPediatric ADHD monotherapy for patients ages 7 through 12 who are not taking prescription ADHD medication

Electrical stimulation for essential tremor

Therapy typeExternal upper-limb tremor stimulator therapy, also called transcutaneous afferent patterned stimulation (TAPS)

Session duration60-minute therapy sessions

Intended useReduce essential tremor symptoms

Powered muscle stimulator

Device descriptionElectronically powered device intended for medical purposes

MechanismRepeatedly contracts muscles by passing electrical currents through electrodes contacting the affected body area

FDA status exampleMore than 30 devices have FDA 510(k) approval

FES/NMES

MeaningFunctional electrical stimulation/neuromuscular electrical stimulation

AbbreviationsFES/NMES

Examples describedParastep Ambulation System, ReWalk, WalkAide, NESS L300, MyGait, Foot Drop Stimulator, and RT300

CES

MeaningCranial electrotherapy stimulation

AbbreviationCES

Examples describedAlpha-Stim Cs, BR-2 Biorest, CES Ultra, NET-2000 Microcurrent Stimulator, and TESA-1

IFC/IFS

MeaningInterferential current/interferential frequency stimulation

AbbreviationsIFC/IFS

Examples describedMedstar 100, RS-4i, and IF-4000