Constraint-Induced Therapy

CIMT is considered medically necessary only for upper‑limb hemiparesis after stroke in patients with at least 10° of active wrist and finger extension and no sensory or cognitive deficits (covered for specified I69.xx and I69.331–I69.339 codes when criteria met). CIMT is experimental/investigational (not covered) for cerebral palsy, congenital hemiplegia, brachial plexus palsy, hemiplegia from brain tumors, lower‑limb hemiparesis post‑stroke, MS, Parkinson’s, spinal cord injury, TBI, and when combined with peripheral nerve stimulation, tDCS, TMS, or biofeedback.

"If billing using ICD-10 codes listed as 'covered if selection criteria are met', documentation must support that the patient meets the selection criteria referenced in the policy (see above)."

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