Tongue Neurostimulation for Obstructive Sleep Apnea - MEDICAID - SOUTH CAROLINA

This policy addresses tongue/translingual neuromuscular electrical stimulation devices for obstructive sleep apnea—oral removable mouthpiece systems (e.g., eXciteOSA) and their power/control units and monitoring components (HCPCS E0490–E0493, A9279). It is directed at patients with snoring or mild OSA (AHI <15) using a daytime regimen (≈20 minutes/day for 6 weeks then twice weekly), but the policy states there is insufficient evidence, deems the therapy not medically necessary, and indicates members (e.g., Humana) may not be eligible with no covered indications listed.

"No explicit covered indications are stated in this excerpt."

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