Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Neurology, Neurosurgery, PsychiatryMedium impact
Vagus Nerve Stimulation
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Vagus nerve stimulation is considered medically necessary as a treatment of medically refractory seizures, defined as seizures that occur despite therapeutic levels of antiepileptic drugs, or seizures that cannot be treated with therapeutic levels of antiepileptic drugs because of intolerable adverse events of these drugs. It is considered investigational for depression, heart failure, upper-limb impairment due to stroke, essential tremor, headaches, rheumatoid arthritis, fibromyalgia, tinnitus and traumatic brain injury, including but not limited to these conditions, and transcutaneous (nonimplantable) vagus nerve stimulation devices are investigational for all indications. The 05/21/2026 update changed the policy statement to say vagus nerve stimulation is considered investigational as a treatment of rheumatoid arthritis, and removed ICD-9 procedure and diagnosis codes from the code reference.
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01Billing team: Bill vagus nerve stimulation as covered only for medically refractory seizures as the policy defines them.
02Services for the investigational conditions listed above are considered investigational under this policy, and transcutaneous (nonimplantable) devices are investigational for all indications.
03Vagal nerve stimulation requires the surgical implantation of the device, plus subsequent neurostimulator programming, which occurs intraoperatively and typically during additional outpatient visits.
04The listed codes are only medically necessary when the procedure is performed according to the policy section.
05BCBSMS makes no payment for services that are not documented to be medically necessary, so the chart must document medical necessity.
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