Infrared Therapy Devices

This policy addresses infrared therapy devices (including infrared/near‑infrared light, heat, and monochromatic infrared energy) and states these devices and related accessories are considered not medically necessary and non‑covered for indications such as diabetic and non‑diabetic peripheral sensory neuropathy, wounds/ulcers, and similar conditions. An Illinois‑only exception (Public Act 103‑0458) provides coverage for children clinically or genetically diagnosed with a disease/syndrome/disorder that includes low‑tone neuromuscular, neurological, or cognitive impairment for fully insured PPO/HMO/POS plans amended/delivered/issued/renewed on or after 2025‑01‑01, but any coverage is subject to the member’s contract/SPD, benefit limits, coding guidance (clinic 97026, home E0221), local carrier discretion, and current Medicare NCDs.

"Illinois-only exception: Coverage for therapy, diagnostic testing, and equipment necessary to increase quality of life for children clinically or genetically diagnosed with a disease/syndrome/disor..."