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Gait Analysis and Electrodynogram (CPB 0263, reviewed 2026-04-16)
Aetna·Physical Therapy, Orthopedics, Pediatrics +3 more·Medical Policy
Effective date
Apr 16, 2026
We identified it
Aug 14, 2026
Summary
Aetna has classified gait analysis (CPT 96000, 96001, 96002, 96004), dynamic electromyography, electrodynogram, and wearable devices for running gait analysis as experimental, investigational, or unproven for all indications. These procedures are NOT covered and claims will be denied. This policy was reviewed/updated on April 16, 2026.
Action Required
Effective immediately (as of April 16, 2026): Billing team must update billing software to DENY all claims for CPT codes 96000, 96001, 96002, and 96004 when submitted to Aetna. Add a billing block or note in the system: 'Gait analysis and electromyography NOT COVERED by Aetna - experimental/investigational.' Update encounter templates and provider education materials to inform clinicians that these procedures are non-covered. Do NOT bill these codes to Aetna; if providers still order them, inform patients these are patient-responsibility charges. Flag all pending claims for these codes submitted to Aetna and reprocess or withdraw before payment. Verify no wearable device gait analysis claims are submitted under any CPT code.