Electrical stimulation for indications other than wound care is considered medically necessary when performed as an integral part of the therapy plan of care.
Effective April 1, 2001, pelvic floor electrical stimulation with a non-implantable stimulator is covered for the treatment of stress and/or urge urinary incontinence in cognitively intact patients who have failed a documented trial of pelvic muscle exercise (PME) training. A failed trial of PME is defined as no clinically significant improvement in urinary continence after completing 4 weeks of an ordered plan of pelvic muscle exercises designed to increase periurethral muscle strength.
This modality does not require direct (one-on-one) patient contact by the provider.
Medicare considers the following indications noncovered:
Electrical stimulation used in the treatment of facial nerve paralysis, commonly known as Bell’s Palsy, is considered investigational and noncovered
Electrical stimulation used to treat motor function disorders, such as multiple sclerosis, is considered investigational and noncovered
Electrical stimulation used for the treatment of strokes when there is no potential for restoration of function