Functional neuromuscular electrical stimulation using any device is considered investigational for all indications, including ambulation in individuals with spinal cord injury, restoring upper or lower extremity function in individuals with nerve damage, improving ambulation in individuals with foot drop caused by congenital disorders or nerve damage, and treatment of pain. There is not enough research to show that NMES improves health outcomes for individuals with spinal cord injury, stroke, congenital disorders, nerve damage, pain, or other conditions, and additional randomized controlled trials comparing this combined therapy to standard treatment are needed. Contracts exclude from coverage services or procedures that are considered investigational, and providers may bill members for them.
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01Already effective November 1, 2026: Before rendering functional neuromuscular electrical stimulation, providers are encouraged to inform members that the members are likely to be financially responsible for the cost of these services, because they are considered investigational.
02Benefit determinations are based on the applicable contract language, and the contract language takes precedence over the medical policy, so check the member's contract before making a benefit determination.
03Providers may bill members for services that are considered investigational.
04Check current applicability of this policy against the source link before relying on it.
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