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11.14.13h, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
Independence Blue Cross has reissued Policy 11.14.13h confirming that Extracorporeal Shock Wave Therapy (ESWT) for musculoskeletal conditions remains experimental/investigational and NOT COVERED for all diagnoses and all musculoskeletal applications. This is a reaffirmation of existing policy with no substantive changes—the most recent reissuance occurred on 03/04/2026 as part of the annual review process.
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What to do
Action · 5 steps
01No immediate action required.
02This is a policy reaffirmation with no changes to coverage status or billing guidance.
03Billing team should verify that claims for CPT codes 0101T, 0102T, 28890, and 20999 (ESWT-related codes) continue to be denied as non-covered experimental/investigational services.
04No system changes needed unless previous billing rules were incorrect.
05If your practice has been billing ESWT for musculoskeletal conditions, confirm all such claims are being properly denied and that patients are being notified of non-coverage prior to service delivery.
Codes mentioned
2889020999
Original notice
11.14.13h, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA11.087c, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal ConditionsMediumNo effective date · Medical PolicyMA11.087c, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal ConditionsLowNo effective date · Medical Policy11.14.13h, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal ConditionsLowNo effective date · Medical PolicyMA05.018d, Non-Spinal Osteogenic Stimulators (Electrical and Ultrasonic)MediumEffective Sep 9, 2024 · Medical PolicyBrowse every Independence Blue Cross change in the policy list