WASHINGTON -- Medicare will no longer cover most uses of transcutaneous electrical nerve stimulation (TENS) for chronic low back pain, according to a memo issued by the Centers for Medicare and Medicaid Services (CMS).
Reimbursement for TENS for low back pain will be available only when patients are participating in a randomized, controlled trial of the technology's clinical effectiveness, CMS officials wrote in the final decision, which was released Friday and is effective immediately.
"TENS is not reasonable and necessary for the treatment of [chronic low back pain]," they wrote.
Currently, Medicare pays for FDA-approved TENS equipment and supplies when prescribed by a physician for chronic intractable pain and reimburses physicians and physical therapists for evaluating patients' suitability for the treatment, which is typically used at home.
TENS units are usually small, portable battery operated devices that deliver electrical currents to the skin through electrodes.
CMS decided on its own to review its coverage of TENS for chronic low back pain in the wake of a 2010 report by an American Academy of Neurology panel that found the treatment was not effective.That panel had conducted a systematic review of published studies of TENS and concluded there was "conflicting evidence for the use of TENS in the treatment of chronic low back pain and that TENS should be deemed ineffective for this purpose."
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