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United Healthcare Will Expand Neurostimulation Coverage

Jan 20, 2022, 19:59 PM by ASRA Pain Medicine

As we announced back in December, the Multisociety Pain Workgroup (MPW) wrote to United Healthcare regarding its medical policy that designated safe and effective neuromodulation procedures as “not medically necessary.” 

As the MPW stated, dorsal root ganglion stimulation (DRG-S) and percutaneous peripheral nerve stimulation (PNS) both have a proven track record of safety and efficacy despite what the UHC policy stated. 

In response to the comments, United Healthcare agreed to expand indications for implanted electrical spinal cord stimulators effective March 2022. According to the policy, "Implanted electrical spinal cord stimulators, including high-frequency spinal cord stimulators and burst spinal cord stimulators are proven and medically necessary for treating the following ... 

  • Complex regional pain syndrome (CRPS)
  • Diabetic Neuropathy
  • Failed back surgery syndrome"

ASRA Pain Medicine was one of 12 medical societies, including the American Society of Anesthesiologists, that advocated for the change.

The coverage is especially important in light of the need for non-opioid options for patients with chronic pain.

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