Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation Therapy

This policy addresses percutaneous electrical nerve stimulation (PENS), percutaneous neuromodulation therapy (PNT), and restorative neurostimulation (including devices such as ReActiv8) as treatments for chronic musculoskeletal and neuropathic pain conditions—e.g., chronic low back and neck pain, diabetic neuropathy, and chronic headache—and as potential salvage options after failure of other therapies (such as PENS when TENS is ineffective). However, the policy concludes the evidence is poor/insufficient and therefore deems PENS, PNT, and restorative neurostimulation experimental/investigational and not covered, with coding guidance to use unlisted CPT 64999 (implantation CPTs not appropriate) and notes limited short‑term pain benefit without demonstrated durable functional improvement.

"Chronic musculoskeletal pain conditions"

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