Deep Brain Stimulation for Essential Tremor and Parkinsons Disease
NCD279
Medicare covers unilateral or bilateral VIM DBS for essential tremor or tremor-dominant idiopathic Parkinson's disease and STN or GPi DBS for advanced idiopathic Parkinson's disease when FDA-approved devices (or Category B IDE trial use) are used and strict patient-selection criteria are met (diagnostic criteria, documented severity or advanced disease, L-dopa responsiveness for PD, failure of optimal medical therapy, and patient cooperation). Coverage excludes non-idiopathic PD/Parkinson-plus syndromes, patients with significant cognitive/psychiatric/substance-use disorders, structural lesion etiologies, prior surgery in the target basal ganglion, or comorbidities that contraindicate surgery; provider and facility qualifications and specified documentation (scales, imaging, consent) are required.
"DBS is covered only when devices are FDA-approved for DBS or used under FDA Category B IDE clinical trial protocols."