Vagus Nerve Stimulation (VNS)

This policy covers implantable vagus nerve stimulation (VNS) for medically refractory or treatment‑resistant epilepsy—used as adjunctive therapy for partial (and, in some evidence, generalized) seizures, including patients intolerant of antiseizure drugs or with failed resective surgery. Transcutaneous (nonimplantable) VNS and VNS for non‑seizure indications (e.g., depression, heart failure, stroke rehab, tinnitus, obesity) are considered experimental/investigational and not covered; coverage generally requires prior therapy failure and documentation with validated outcome measures, with an Illinois‑only exception mandating coverage for certain children with neuromuscular/neurological/cognitive impairments.

"Vagus nerve stimulation (VNS) may be considered medically necessary for treatment of medically refractory seizures."

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