11 commercial payer policies list A4540. 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.
11 policies from 10 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of A4540 |
|---|---|---|
| Electrical Stimulation as a Treatment for Pain and Other Conditions: Surface and Percutaneous Devices | Mar 6, 2025 | Not covered |
| Surface Electrical Stimulation Devices for Headache and Migraine | Mar 6, 2025 | Covered |
| Policy | Effective | Status of A4540 |
|---|---|---|
| Remote Electrical Neuromodulation for Migraines | Dec 15, 2025 | Covered |
| Policy |
|---|
| Effective |
|---|
| Status of A4540 |
|---|
| Remote Electrical Neuromodulation for Migraines | Dec 15, 2025 | Covered |
|---|
| Policy | Effective | Status of A4540 |
|---|---|---|
| Remote Electrical Neuromodulation for Migraines | Dec 15, 2025 | Covered |
| Policy | Effective | Status of A4540 |
|---|---|---|
| Remote Electrical Neuromodulation for Migraines | Dec 15, 2025 | Covered |
| Policy | Effective | Status of A4540 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List - Effective 01/01/2025 | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of A4540 |
|---|---|---|
| Transcutaneous Electrical Modulation Pain Reprocessing | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4540 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4540 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4540 |
|---|---|---|
| Occipital Nerve Injections and Ablation (Including Occipital Neuralgia and Headache) | Jan 1, 2026 | Covered |