Payer PolicyActive
Pulsed Radiofrequency
AETNA-CPB-0735
Aetna
Effective: September 20, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna considers pulsed radiofrequency experimental and investigational for all indications (including abdominal cutaneous nerve entrapment, carpal tunnel, cervical radicular pain, chronic hip pain) and therefore not covered. Specific modalities/devices (e.g., Stimpod NMS460, wearable PRF for post‑amputation pain) are likewise excluded, there are no specific CPT/HCPCS codes identified, and the policy lists numerous example ICD‑10 diagnoses as noncovered because effectiveness has not been established.
Coverage Criteria Preview
Key requirements from the full policy
"G52."
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