Surface Electrical Stimulation

This policy addresses surface electrical stimulation devices and therapies (e.g., H‑Wave, threshold stimulation, microcurrent, galvanic, electroceutical approaches, dysphagia and scoliosis devices, geko-type circulatory devices) for conditions including pain, edema, wound healing, post‑operative function, motor disorders (including cerebral palsy), dysphagia, scoliosis, and muscle weakness in advanced disease. However, surface electrical stimulation is considered experimental, investigational and/or unproven for any indication and is not covered; coverage is subject to the member’s benefit plan and state regulations, and the policy excludes or defers to other policies for specific modalities (e.g., cranial electrotherapy, TENS, interferential, functional neuromuscular stimulation) while noting 510(k) clearance does not establish clinical effectiveness.

"H-Wave electrical stimulation for treatment of pain"