Complementary and Alternative Medicine - (EN0086)

This policy states that many complementary and alternative medicine modalities (e.g., applied kinesiology, iridology, chemical hair analysis, Ayurveda, homeopathy, naturopathy, cupping, Reiki, hypnosis, yoga, numerous supplements, and multiple specific CPT/HCPCS codes) are considered experimental, investigational, or unproven and are not supported as covered services; no CAM therapies are explicitly listed as covered in this excerpt and actual coverage varies by plan. Key requirements: coverage is determined by the customer’s benefit plan and applicable laws/policies, claims must use appropriate procedure and diagnosis codes and match covered indications or they will be denied, prescription drugs are handled under the pharmacy benefit, and medical directors retain discretion for individual determinations.

"Coverage for complementary and alternative testing and therapies varies across plans. Please refer to the customer's benefit plan document for coverage details."