Extracorporeal Shock Wave Therapy (ESWT)

This A/B MAC policy states that high-energy extracorporeal shock wave therapy (ESWT) is not reasonable and necessary for treatment of musculoskeletal conditions and therefore is not covered. The policy specifically cites conditions such as calcific tendinopathy of the shoulder, lateral/medial epicondylitis, carpal tunnel syndrome, greater trochanteric pain syndrome, fractures/delayed unions/nonunions, osteonecrosis of the femoral head, and patellar tendinopathy, and notes the list is not exhaustive.

"High-energy extracorporeal shock wave therapy (ESWT) is considered not reasonable and necessary for treatment of musculoskeletal conditions and is not covered."

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