Does D9948 require prior authorization?

No, D9948 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for D9948?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

Verity

`D9948` — Adjust sleep apnea appliance

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

None specified in this policy bulletin.

Key Coverage Criteria

None. Aetna considers intra-oral appliances (e.g., the Nociceptive Trigeminal Inhibition-Tension Suppression System) experimental and investigational for the treatment of headaches and trigeminal neuralgia because the effectiveness of this approach for these indications has not been established.

5 Active Policies

AETNA-CPB-0688 — Intra-oral Appliances for Headaches and Trigeminal Neuralgia

CARELON-sleep-disorder-management-2025-11-15 — Sleep Disorder Management

CARELON-sleep-disorder-management-2023-09-10 — Sleep Disorder Management

CARELON-sleep-disorder-management-2024-10-20-updated-2025-07-01-for-anthem-bcbs-ohio-medicaid-and-regence-only-deferred-to-2025-12-01 — Sleep Disorder Management

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D9948 — Adjust sleep apnea appliance