Noncontact Ultrasound Treatment for Wounds

This policy addresses noncontact low‑frequency ultrasound (NLFU/MIST) therapy as an adjunct to standard wound care for acute and chronic wounds—including diabetic foot ulcers, venous leg ulcers, pressure ulcers, split‑thickness graft donor sites, and other lower‑limb chronic wounds. However, NLFU/MIST is considered experimental, investigational and not covered under this policy because evidence is limited, heterogeneous, and device‑specific (small, potentially biased RCTs with inconsistent results); coverage would require robust evidence of superior wound‑closure outcomes versus standard care, with an Illinois exception effective 2025‑01‑01 for certain children with neuromuscular/neurological/cognitive impairment.

"Illinois exception (effective for plans amended/delivered/issued/renewed on or after 2025-01-01): coverage required for therapy, diagnostic testing, and equipment necessary to increase quality of l..."