Payer PolicyActive
Guillain-Barre Syndrome Treatments
AETNA-CPB-0732
Aetna
Effective: September 22, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna covers IVIG (HCPCS 90283), therapeutic plasmapheresis (CPT 36514), and outpatient pulmonary rehabilitation for Guillain‑Barré syndrome only when the specific medical‑necessity/selection criteria in CPB 0206 (IVIG), CPB 0285 (plasmapheresis) and CPB 0032 (pulmonary rehab) are met. Therapies considered experimental/investigational and not covered for GBS include corticosteroids (not recommended), alemtuzumab, eculizumab, rituximab, interferons, acupuncture, neuromuscular electrical stimulation and numerous listed J‑codes/agents.
Coverage Criteria Preview
Key requirements from the full policy
"Outpatient pulmonary rehabilitation program for patients with Guillain-Barre syndrome when criteria listed in CPB 0032 - Pulmonary Rehabilitation are met."
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