R25.8 coverage policies: Medicare and commercial payers

54 active Medicare policies list R25.8, and 1 commercial payer policy lists 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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Medicare policies listing R25.8

LCD · CGS-J15-L39856

Botulinum Toxin Injections

J15

LCD · WPS-J5-L39908

Botulinum Toxin Injections

LCD · WPS-J8-L39908

Botulinum Toxin Injections

LCD · PALMETTO-JJ-L37641

Continuous Peripheral Nerve Blocks (CPNB)

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37641

Continuous Peripheral Nerve Blocks (CPNB)

JM · Effective Jan 29, 2018

LCD · PALMETTO-JJ-L34417

CT of the Head

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34417

CT of the Head

JM · Effective Oct 1, 2015

LCD · NGS-J6-L33399

EEG â Ambulatory Monitoring

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33399

EEG â Ambulatory Monitoring

JK · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L39400

Magnesium

JJ · Effective Jan 22, 2023

LCD · PALMETTO-JM-L39400

Commercial payer policies listing R25.8

1 policy from 1 payer

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Cigna

Cigna policies listing R25.8, with the code’s status in each
Policy	Effective	Status of R25.8
ElectroencephalographyPayerPolicy · CIGNA-0521	Feb 15, 2026	Covered