Autonomic Nerve Function Testing - Medicare Advantage

This Medicare Advantage policy addresses autonomic nerve function testing — including parasympathetic and sympathetic assessments (heart‑rate responses, Valsalva, tilt‑table), sudomotor testing (QSART, thermoregulatory sweat testing), quantitative pilomotor testing and related procedures (CPTs 95921–95924, 95999) — for evaluation of suspected autonomic dysfunction such as syncope (including vasovagal syncope), POTS, inappropriate sinus tachycardia, autonomic neuropathy (including diabetic neuropathy), ME/CFS with suspected autonomic involvement, unexplained flushing, and related indications. Coverage is governed by CMS LCD L35124 and any policy‑specific limits (frequency/diagnoses/prior treatments) not reproduced here; several modalities (e.g., Sudoscan/ESC, QDIRT, automated testing without physician interpretation) are considered investigational or insufficiently validated, and listing of CPT codes does not guarantee reimbursement.

"Testing for autonomic dysfunction"