Back to dashboard
CommercialCoverageMedium impact

Heating Devices (CPB 0540, reviewed 2026-07-31)

Aetna·Physical Therapy, PM&R (Physical Medicine & Rehab), Rheumatology +3 more·Medical Policy
Effective date
Jul 31, 2026
We identified it
Aug 17, 2026
Days to comply

Summary

Aetna's Heating Devices policy (CPB 0540, effective 2026-07-31) establishes coverage criteria for heating pads and related devices. Electric heating pads are covered for pain relief and muscle/joint stiffness, but heating pads are NOT covered for peripheral neuropathy (including diabetic neuropathy). Multiple devices classified as experimental/unproven (water-circulating pads, infrared systems, heat lamps, PainShield MD) and institutional equipment (hydrocollator units, diathermy devices) are not covered for home use.

Action Required

Action needed
By 2026-07-31, billing team must: (1) Update claim edits to DENY coverage for E0200, E0205, E0217, E0218, E0221, E0225, E0236, E0239, E0249, K1004, and K0136 (experimental/unproven and institutional devices); (2) Add automated rejection for heating pad claims (E0210, E0215) when ICD-10 codes E08.40-E08.49, E09.40-E09.49, E10.40-E10.49, E11.40-E11.49, E13.40-E13.49, G90.01-G90.9, or G99.0 (peripheral neuropathy/diabetic neuropathy) are submitted; (3) Ensure prior authorization is applied to requests for multiple heating devices for same condition (CPT 97010, 97018 or HCPCS E0210, E0215); (4) Reject A9273 (hot water bottles) as non-covered DME; (5) Educate providers that only standard electric heating pads (E0210/E0215) are covered for approved indications and only one device per condition is typically approved. Failure to implement denials will result in improper claim payments.

Affected Billing Codes

97010
97018
97024
97026
97035
A4265
E0210
E0215
E0235
A9273
E0200
E0205
E0217
E0218
E0221
E0225
E0236
E0239
E0249
K1004
K0136