Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor

MRgFUS unilateral thalamotomy is covered for adults aged >=22 with medication-refractory essential tremor who have moderate-to-severe dominant-hand tremor (CRST >=2), disabling tremor (CRST disability >=2), are not candidates for DBS, and have acceptable skull density ratio and MRI eligibility. Coverage is denied for head/voice tremor, bilateral thalamotomy, advanced neurodegenerative disease, unstable cardiac disease, severe depression or cognitive impairment (MMSE <24), SDR <0.40, or any MRI contraindication; providers must document medication trials, objective CRST scores, DBS ineligibility, SDR, MRI clearance, cognitive assessment, and provider qualifications per ASSFN.

"Magnetic-resonance-guided focused ultrasound (MRgFUS) unilateral thalamotomy is covered for essential tremor that is medication-refractory, defined as failure of at least two trials of medical ther..."