Sacral Nerve Stimulation 7.01.10
Excellus BlueCross BlueShield policy 7.01.10, Sacral Nerve Stimulation, has a current effective date of March 16, 2026. The November 20, 2025 off-cycle review clarified the sacral nerve stimulation trial and permanent placement criteria. Sacral nerve stimulation is medically appropriate for individuals 16 and older who meet both the trial stimulation and permanent placement criteria, and it is considered investigational for stress incontinence, urge incontinence due to a neurological condition, other chronic voiding dysfunction, constipation, chronic pelvic pain and bilateral sacral nerve stimulation.