MED.00011 Sensory Stimulation for Brain-Injured Individuals in Coma or Vegetative State

This policy addresses structured sensory stimulation (coma arousal therapy/multisensory stimulation) for brain‑injured individuals in a coma or vegetative state, including visual, auditory, tactile, taste/smell, and mobility stimulation. Anthem deems these services investigational and not medically necessary—therefore not covered—in all settings, by any provider (including family), and at any intensity or frequency. No covered indications are specified; related codes include 97139, 97799, and S9056.

"Sensory stimulation (also known as: coma stimulation sessions, coma arousal therapy, multisensory stimulation programs and coma care) for brain injured individuals in a coma or vegetative state is ..."

Sign up to see full coverage criteria, indications, and limitations.