All PlansCoverageMedium impact
Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions
Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Podiatry, PM&R (Physical Medicine & Rehab) +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This policy establishes coverage criteria for extracorporeal shock wave therapy (ESWT) for plantar fasciitis and other musculoskeletal conditions. The policy defines when ESWT is considered medically necessary, specifies FDA-approved devices, and outlines treatment protocols for various conditions including tendinitis, fracture nonunion, and chronic pain syndromes.
Action Required
Immediately: Review current ESWT billing practices to ensure compliance with new coverage criteria. Verify that treatments are limited to FDA-approved devices listed in the policy (OssaTron, Epos Ultra, Sonocur Basic, etc.). Document that conservative therapy has failed for at least 6 months before ESWT treatment. Update prior authorization requests to include specific device information and treatment protocols (high-dose vs low-dose) as defined in the policy.