Payer PolicyActive
Histamine Desensitization Therapy for Intractable Headaches
AETNA-CPB-0647
Aetna
Effective: September 13, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna considers histamine desensitization therapy experimental and investigational and does not cover it for intractable headaches (including chronic cluster headaches and migraines). It is excluded because effectiveness has not been established by randomized controlled trials, specifically for ICD‑10 codes G43.001–G43.919 (migraines), G44.001–G44.029 (cluster headaches), G44.1 (vascular headache NEC), and G44.201–G44.229 (tension‑type headaches).
Coverage Criteria Preview
Key requirements from the full policy
"None — Aetna considers histamine desensitization therapy (e."
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