CMM-402: Greater Occipital Nerve Injections and Ablation

Greater occipital nerve blocks with anesthetic and/or steroid for occipital neuralgia are covered (up to six in 12 months, with ≥4 weeks between GONB and specified cervical procedures), while non‑steroid/anesthetic injectates (e.g., biologics) and any occipital nerve ablation are not covered. Coverage requires documented diagnosis and comprehensive headache evaluation excluding other causes, documentation of clinically meaningful improvement for repeat injections, use of a self‑care program, and for patients on opioids ≥3 months, behavioral‑health co‑management and an opioid risk‑mitigation plan.

"In regards to greater occipital nerve blocks, this guideline only applies to greater occipital nerve blocks used to treat occipital neuralgia and not to other techniques used to treat occipital neu..."

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