Peripheral Nerve Stimulation
JE · Effective Oct 1, 2015
3 active Medicare policies list 64553, and 34 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
Free account. Policy pages stay open to everyone.
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
National · Effective Oct 23, 2025
34 policies from 13 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 64553 |
|---|---|---|
| Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments | Feb 20, 2024 | Covered |
| Epilepsy Surgery | Feb 27, 2024 | Covered |
| Headaches: Invasive Procedures | Feb 20, 2024 | Covered |
| Trigeminal Neuralgia: Treatments | Feb 15, 2024 | Covered |
| Vagus Nerve Stimulation | Feb 9, 2024 | Covered |
| Vocal Cord Paralysis / Insufficiency Treatments | May 5, 2023 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Bariatric Surgery and Procedures | Jul 15, 2026 | Not covered |
| Cigna Commercial Other Services Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Headache, Occipital, and/or Trigeminal Neuralgia Treatment | Jun 15, 2026 | Not covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation Therapy | Oct 15, 2025 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation Therapy | Oct 15, 2025 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation Therapy | Oct 15, 2025 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation Therapy | Oct 15, 2025 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Implantation of Occipital, Supraorbital or Trigeminal Nerve Stimulation Devices (and Related Procedures) | Oct 1, 2026 | Not covered |
| Vagus Nerve Stimulation | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Stimulation | Jun 1, 2026 | Covered |
| Vagus Nerve Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Oct 1, 2026 | Covered |
| Vagus and External Trigeminal Nerve Stimulation | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Oct 1, 2026 | Covered |
| Vagus and External Trigeminal Nerve Stimulation | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Oct 1, 2026 | Covered |
| Vagus and External Trigeminal Nerve Stimulation | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Vagus Nerve Stimulation | Not recorded | Covered |
| Policy | Effective | Status of 64553 |
|---|---|---|
| Electrical Stimulators | Not recorded | Covered |