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AetnaAll Plans · Coverage · Medical Policy · Oncology, Dentistry, Oral & Maxillofacial Surgery +7 moreMedium impact

Cold Laser and High-Power Laser Therapies (CPB 0363, reviewed 2026-07-15)

Effective date
Not stated in the notice
Identified
Aug 15, 2026

Summary

Aetna's clinical policy bulletin CPB 0363 addresses cold laser (low-level laser therapy, class III) and high-power laser (class IV) therapies. Aetna considers low-level laser therapy medically necessary for prevention of oral mucositis in persons undergoing cancer treatment with an increased risk of oral mucositis, including chemotherapy and/or radiotherapy, and/or hematopoietic stem cell transplantation. Aetna considers cold laser therapy, high-power laser therapy, and low-level laser therapy using dynamic photonic and dynamic thermokinetic energies experimental, investigational, or unproven for other indications, including Achilles tendinopathy, carpal tunnel syndrome, knee osteoarthritis, plantar fasciitis, rheumatoid arthritis, shoulder impingement syndrome, tinnitus, and tendon repair, because there is inadequate evidence of their effectiveness for those indications. CPT 97037 and HCPCS S8948 are listed as not covered for the indications in the policy.

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What to do

Action · 3 steps
01Billing team: Claims for CPT 0552T, CPT 1011T, or ICD-10 K12.30 through K12.39 for low-level laser therapy are covered if the policy's selection criteria are met, for prevention of oral mucositis in persons with increased risk during cancer treatment.
02Claims for CPT 97037 and HCPCS S8948 for the indications listed in the policy are not covered.
03Services for the experimental, investigational, or unproven indications listed in the policy are considered experimental, investigational, or unproven.

Codes mentioned

97037S8948K12.30K12.39

Original notice

Cold Laser and High-Power Laser Therapies (CPB 0363, reviewed 2026-07-15)
aetna.com · Always check the source before changing claims.
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