Payer PolicyActive
Xerostomia: Selected Treatments
AETNA-CPB-0302
Aetna
Effective: May 8, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna considers several treatments for xerostomia—specifically electrical stimulation devices (e.g., Salitron, Saliwell Crown) for prevention or treatment, acupuncture, ALTENS, adipose-derived mesenchymal stem cell therapy, and fat grafting to salivary glands—experimental and investigational and therefore not covered because their effectiveness has not been established; the bulletin lists no explicitly covered interventions.
Coverage Criteria Preview
Key requirements from the full policy
"The list of experimental and investigational interventions is not all-inclusive; other unlisted interventions may also be considered experimental/investigational if effectiveness is not established."
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