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AetnaCommercial · Coverage · Medical Policy · Anesthesiology, Pain Management, Emergency MedicineMedium impact

Sufentanil Sublingual Tablet (Dsuvia) (CPB 0944, reviewed 2025-12-09)

Effective date
Not stated in the notice
Identified
Aug 17, 2026

Summary

Aetna considers sufentanil sublingual tablet (Dsuvia) not medically necessary for the treatment of acute pain severe enough to require an opioid analgesic, because safety for this indication has not been established. Aetna considers Dsuvia experimental, investigational, or unproven for all other indications, because its safety and effectiveness have not been established in the peer-reviewed published medical literature. The policy applies to commercial medical plans and lists the recommended dose of 30 mcg sublingually, administered by a healthcare provider in a certified medically supervised healthcare setting.

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What to do

Action · 3 steps
01Billing team: Stop billing Dsuvia for acute pain severe enough to require an opioid analgesic and for all other indications in this policy, because Aetna considers it not medically necessary for the first use and experimental, investigational, or unproven for the others.
02Dsuvia has no specific HCPCS code, and the policy lists it as not covered for these indications.
03The ICD-10 codes G89.11 through G89.18 for acute pain are listed as not covered for the indications in this policy.

Codes mentioned

G89.11G89.18

Original notice

Sufentanil Sublingual Tablet (Dsuvia) (CPB 0944, reviewed 2025-12-09)
aetna.com · Always check the source before changing claims.
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Related changes

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Related policy hubs

Aetna policiesAnesthesiologyPain ManagementEmergency MedicineCode G89.11Code G89.18

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