Payer PolicyActive
Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions - (0004)
CIGNA-ESWT
Cigna
Effective: November 15, 2025
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
ESWT is considered experimental/investigational/unproven for ALL musculoskeletal conditions and is not covered under this policy (Cigna excludes musculoskeletal ESWT even though some devices have FDA PMA approvals for plantar fasciitis and lateral epicondylitis). Coverage may vary by plan—claims lacking covered diagnosis/procedure codes will be denied, providers must use current effective CPT codes, and you must follow the applicable benefit plan document for plan-specific requirements.
Coverage Criteria Preview
Key requirements from the full policy
""Extracorporeal shock wave therapy (ESWT) is considered experimental, investigational or unproven for the treatment of ANY musculoskeletal condition."
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