Occipital Nerve Stimulation

This policy addresses occipital nerve stimulation (implantable peripheral nerve stimulation) as a treatment for headache and craniofacial pain conditions including migraine (chronic or refractory), cluster headache, hemicrania continua and other refractory headache disorders. The policy deems occipital nerve stimulation experimental, investigational and not medically necessary for all indications — noting no FDA‑approved device for headache, limited/insufficient randomized evidence, substantial device complication rates, and that coverage is subject to the member’s benefit plan/contract.

"None — occipital nerve stimulation is considered experimental, investigational and/or unproven for all indications and therefore not a covered, medically necessary therapy."

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