Vagus Nerve Stimulation

This policy covers implantable vagus nerve stimulation (VNS), primarily chronic intermittent left cervical VNS, as adjunctive therapy for medically refractory epilepsy and (FDA‑approved) treatment‑resistant major depressive disorder. Coverage is limited to patients with intractable epilepsy (persistent seizures despite ≥1 year of adherent therapy with ≥2 antiseizure drugs who are not surgical candidates or have failed surgery) using an FDA‑approved implantable device, while many other indications and devices (including transcutaneous VNS and the AspireSR Model 106) are considered investigational/not covered due to limited or low‑quality evidence, modest efficacy, and safety/selection uncertainties.

"Adjunctive therapy for medically refractory epilepsy using chronic intermittent stimulation of the left vagus nerve."

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