Low-Level Laser Therapy

This policy covers low‑level laser therapy (LLLT) for prevention of oral mucositis in patients receiving cancer treatment (chemotherapy, radiotherapy, or hematopoietic cell transplantation) and for a variety of musculoskeletal, soft‑tissue, wound‑healing and neurologic conditions (e.g., carpal tunnel, neck pain, shoulder impingement, frozen shoulder, low back pain, knee osteoarthritis, plantar fasciitis, lymphedema), with an Illinois mandate requiring coverage for certain pediatric neuromuscular/neurologic/cognitive disorders effective 2025‑01‑01. Major limitations include that LLLT is considered experimental/investigational for indications not explicitly listed, coverage and indications are device‑ and FDA 510(k)‑specific, clinical evidence is limited (so LLLT is not a criterion standard), and specific timing/regimens apply for mucositis prophylaxis (typically from day 0 through treatment or, for HCT, started between day −7 and 0 and continued through ~day 14–15); head/neck radiotherapy prophylaxis is indicated only without concurrent chemotherapy.