CMM-210: Implantable Intrathecal Drug Delivery Systems

Implantable intrathecal or epidural drug delivery systems (including intrathecal baclofen) are covered for nonmalignant chronic intractable pain, severe refractory spasticity/dystonia unresponsive to oral agents, and cancer‑related pain after failure/intolerance of conservative measures, and are experimental/investigational for all other indications (e.g., insulin, antibiotics, heparin) or conditions not meeting criteria. Coverage requires a prior percutaneous trial with documented objective pathology, failure of ≥6 months of reasonable conservative therapies (for spasticity a ≥6‑week oral antispasmodic + physical therapy trial; for cancer pain failure/intolerance to systemic opioids), participation in aggressive rehabilitation, mental‑health clearance, and ≥50% pain reduction during the trial for permanent implantation.

"Nonmalignant, chronic intractable pain (e."