Biofeedback for Behavioral Health Disorders

This policy covers biofeedback interventions (including heart rate variability biofeedback and neurofeedback) as an adjunctive behavioral health treatment to help members gain voluntary control of physiological functions. It is medically necessary primarily for DSM‑5‑TR–diagnosed anxiety disorders and PTSD when members show functional impairment on validated severity scales, are motivated to participate, and have not responded sufficiently to standard evidence‑based outpatient treatments; coverage is limited to up to 25 initial sessions (with up to 20 additional sessions only if criteria remain met and ≥25% documented improvement), must be provided by qualified clinicians, and is not covered as standalone treatment or for non‑behavioral health diagnoses.

"Documented DSM V-TR diagnosis of anxiety disorder or PTSD in the medical record."

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