CommercialCoverageHigh impact
Quantitative Sensory Testing Methods (CPB 0357, reviewed 2026-05-22)
Aetna·Neurology, Pain Management, Orthopedics +5 more·Medical Policy
Effective date
May 22, 2026
We identified it
Aug 15, 2026
Summary
Aetna has updated CPB 0357 to classify Quantitative Sensory Testing (QST) and related procedures as experimental/investigational for a broad range of clinical indications, including chronic pain management, neuropathy evaluation, and post-operative pain assessment. Billing teams must deny claims for CPT codes 0106T-0110T, HCPCS code G0255, and related procedures when billed with the specified ICD-10 diagnosis codes, as these services are no longer covered.
Action Required
By June 22, 2026: Billing team must update claims processing system to automatically deny or flag for review any claims containing CPT codes 0106T, 0107T, 0108T, 0109T, 0110T, or HCPCS code G0255 when paired with ICD-10 diagnosis codes listed in the policy (including but not limited to: G25.81 [restless legs syndrome], G50.0-G59 [nerve disorders], G62.89-G62.9 [neuropathies], M79.7 [fibromyalgia], M25.511-M25.519 [shoulder pain], S13.4XXA-S13.4XXS [whiplash], R10.2 [pelvic pain], L29.0-L29.9 [chronic itch], C50.011-C50.919 [breast cancer], E10.40-E10.49 and E11.40-E11.49 [diabetes with neurological complications], G89.0-G89.29 [pain syndromes]). Update denial templates to cite CPB 0357 as experimental/investigational procedure. Providers and front desk staff should be notified that these services are no longer covered for the specified indications. Failure to implement these changes will result in inappropriate claim payments and potential recovery audits by Aetna.