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CommercialCoverageMedium impact

Specialized Neuromodulation for Specific Conditions 1.01.62

Excellus BlueCross BlueShield·Neurology, Pain Management, Family Medicine +1 more·Durable Medical Equipment & Supplies
Effective date
May 21, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Excellus BlueCross BlueShield now considers Transcutaneous Afferent Patterned Stimulation (TAPS) devices like Cala One/Trio and Remote Electrical Neuromodulation (REN) devices like Nerivio as investigational for all indications, meaning they are not covered benefits. Claims for these neuromodulation devices will be denied as experimental.

Action Required

Action needed
By May 21, 2026: Billing team must update system to deny/flag claims containing HCPCS code A4540 for Excellus BlueCross BlueShield plans as investigational/experimental. Stop billing for Cala One/Trio devices for essential tremor and Nerivio devices for migraine treatment. Inform providers these devices are not covered and patients will be responsible for full cost.

Affected Billing Codes

A4540