Peripheral Nerve Stimulation
JE · Effective Oct 1, 2015
3 active Medicare policies list 64575, and 27 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.
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JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
National · Effective Oct 23, 2025
27 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 64575 |
|---|---|---|
| Headaches: Invasive Procedures | Feb 20, 2024 | Covered |
| Levator Syndrome Treatments | Sep 19, 2023 | Covered |
| Peripheral Electrical Nerve Stimulation for Pain | Feb 8, 2024 | Covered |
| Post-Herpetic Neuralgia | Feb 20, 2024 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Cigna Commercial Interventional Pain Management Code List |
| Mar 7, 2026 |
| Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
|---|
| Diaphragmatic/Phrenic Nerve Stimulation | Jul 15, 2026 | Covered with conditions |
|---|
| Headache, Occipital, and/or Trigeminal Neuralgia Treatment | Jun 15, 2026 | Not covered |
|---|
| Policy | Effective | Status of 64575 |
|---|---|---|
| Diaphragmatic/Phrenic Nerve Stimulation and Diaphragm Pacing Systems | Oct 1, 2026 | Covered |
| Implantable Peripheral Nerve Stimulation Devices as a Treatment for Pain | Jan 6, 2026 | Covered |
| Implantation of Occipital, Supraorbital or Trigeminal Nerve Stimulation Devices (and Related Procedures) | Oct 1, 2026 | Not covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Diaphragmatic/Phrenic Nerve Stimulation | Not recorded | Covered |
| Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | Not recorded | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation and Peripheral Subcutaneous Field Stimulation | Sep 1, 2026 | Covered |
| Occipital Nerve Stimulation | Jun 1, 2026 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Functional Electrical Stimulators (Non-Pain) | Aug 3, 2026 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 64575 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Oct 1, 2026 | Covered |