Covered by Medicare for the treatment of patients with chronic, intractable pain or acute post-operative pain who meet the following:

• The pain must have been present for at least three months, and
• The presumed etiology of pain must be a type which is accepted as responding to TENS therapy; this excludes headache, visceral abdominal pain, pelvic pain, TMJ pain, etc.

Other appropriate treatment modalities must have been tried and failed, and the medical record must document what treatment modalities have been used (including the names and dosage of medication), the length of time that each type of treatment was used, and the results.

When a TENS Unit is used for acute post-operative pain, the medical necessity is limited to 30 days from the day of surgery. Payment will be made only as a rental. A TENS Unit will be denied as not medically necessary for acute paint (less than three months duration) other than post-operative pain.

A one-month trial evaluation of TENS is recommended, to judge its effectiveness in alleviating the patient's pain. Rental of the TENS Unit is covered during this one-month trial usage period. Reimbursement during this one-month trial is limited to the amount which would be payable for the total service, including TENS supplies and evaluation, if provided by the physician or therapist. Coverage of a 4-lead unit requires documentation of why a 2-lead unit is insufficient.

If the initial TENS therapy trial takes longer than one month, documentation of medical necessity must be provided for all services furnished beyond the first month. The trial period is limited to two months.

After the trial period, purchase of the TENS Unit can be covered under the prosthetic devices benefit.

Replacement supplies are covered when they are medically necessary and are used with a TENS Unit that has been purchased.

A physician's written prescription for the TENS Unit must be furnished to the supplier prior to the delivery (WOPD).