Sphenopalatine Ganglion Block for Headache

This policy addresses sphenopalatine ganglion (SPG) block for headache and states SPG blocks (including intranasal catheter delivery) are considered experimental, investigational, and/or unproven and therefore not covered for any headache indication. Although SPG block has been used or studied for episodic and chronic migraine, tension‑type and cluster headaches, postdural puncture and orthostatic headaches, the evidence is limited to a single underpowered RCT (Tx360 device with 0.5% bupivacaine in patients 18–65), long‑term effectiveness and optimal treatment regimen are unestablished, and SPG neurostimulation or radiofrequency procedures are not FDA‑approved.

"None — sphenopalatine ganglion (SPG) blocks are considered experimental, investigational and/or unproven for all headache indications."

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