16 commercial payer policies list S9090. 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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16 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 S9090 |
|---|---|---|
| Axial/Spinal Decompression Therapy/Mechanical Traction (Provided in a Clinic Setting) | Apr 15, 2026 | Not covered |
| Chiropractic Care | Dec 15, 2025 | Not covered |
| Physical Therapy | Dec 15, 2025 | Not covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Lumbar Traction Devices | Aug 9, 2023 | Covered |
| Vertebral Axial Decompression | Apr 4, 2023 |
| Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Mechanized Spinal Distraction Therapy | Oct 1, 2026 | Not covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Vertebral Axial Decompression | Sep 15, 2026 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Vertebral Axial Decompression | Sep 15, 2026 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Vertebral Axial Decompression | Sep 15, 2026 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Vertebral Axial Decompression | Sep 15, 2026 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Physical Therapy Occupational Therapy and Speech Therapy | Apr 14, 2024 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Health Alliance Plan MSK Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Vertebral Axial Decompression | Jul 1, 2026 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Motorized Spinal Traction | May 1, 2026 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Motorized Spinal Traction | May 1, 2026 | Covered |
| Policy | Effective | Status of S9090 |
|---|---|---|
| Motorized Spinal Traction | May 1, 2026 | Covered |