23 commercial payer policies list C1787. 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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23 policies from 11 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of C1787 |
|---|---|---|
| Motor Cortex Stimulation | Oct 6, 2023 | Covered |
| Spasticity Management | Jun 21, 2023 | Covered |
| Trigeminal Neuralgia: Treatments | Feb 15, 2024 | Covered |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Deep Brain Stimulation and Responsive Neurostimulation | Oct 1, 2026 | Covered |
| Implantable Peripheral Nerve Stimulation Devices as a Treatment for Pain |
| Jan 6, 2026 |
| Covered |
| Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring | Oct 1, 2026 | Covered |
|---|
| Policy | Effective | Status of C1787 |
|---|---|---|
| Interventional Pain Management | Jun 14, 2026 | Covered |
| Sleep Disorder Management | Sep 19, 2026 | Covered |
| Sleep Disorder Management [for Wellpoint Massachusetts] | Nov 15, 2025 | Covered |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Cigna Commercial Interventional Pain Management Code List | Mar 7, 2026 | Prior auth required |
| Cigna Commercial Sleep Management Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea | Not recorded | Covered |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Cigna Medicare Advantage Interventional Pain Management Code List | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of C1787 |
|---|---|---|
| Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments | Jun 1, 2026 | Covered |