Posterior Tibial Nerve Stimulation for Voiding Dysfunction

PTNS is covered as a third-line neuromodulation treatment for beneficiaries with overactive bladder syndrome (urinary urgency, frequency, and/or urge incontinence) when an appropriate specialist has determined the patient is a candidate and documentation shows failure of behavioral therapy and at least two medication trials (4–8 weeks each) or intolerance. Coverage requires specialist evaluation, voiding diary evidence of OBS, and documented patient willingness to attend in-office 30-minute sessions; the initial course is one 30-minute session weekly for 12 weeks. Relapse/maintenance treatments are allowed only for patients who achieved >50% symptom reduction during the initial course and then relapse; the policy does not specify a fixed maintenance frequency.

"PTNS is covered for beneficiaries with overactive bladder syndrome (OBS) characterized by urinary urgency, urinary frequency, and/or urge urinary incontinence."