External Upper Limb Tremor Stimulator Therapy

Medicare covers external upper limb tremor stimulators (E0734) and related supplies (A4542) for beneficiaries age ≥18 with a documented diagnosis of essential tremor, baseline BF-ADL ≥3 on at least one eating/drinking/self-care/writing item, and no contraindications, provided at least two pharmacologic therapies have failed or been ruled out and the device is prescribed for the dominant limb as an alternative to invasive surgical options. Initial coverage requires a treating practitioner evaluation and a Standard Written Order; continued coverage beyond the first three months requires a re-evaluation between day 60 and 91 showing ≥1-point BF-ADL improvement in a previously ≥3 item and adherence defined as device use ≥70% of days during a consecutive 30-day period within the first three months. Claims lacking required documentation (SWO/WOPD, POD, correct coding, BF-ADL scores, pharmacologic trial documentation, or re-evaluation/adherence evidence) will be denied.