Aetna · Clinical coverage policy

Aetna Biofeedback coverage criteria

Aetna covers biofeedback as medically necessary for a defined set of indications — cancer pain, chronic constipation due to dyssynergic defecation (confirmed by anorectal manometry), fecal incontinence, irritable bowel syndrome, levator ani syndrome, migraine and tension headaches (EMG/skin/thermal only, not EEG), neuromuscular rehab after stroke/TBI, refractory severe subjective tinnitus, TMJ syndrome, and urinary incontinence. All other uses (60+ conditions, plus EEG biofeedback for headache and any home biofeedback) are considered experimental/investigational, and using biofeedback in non-diseased persons for wellness is not medically necessary. Some plans exclude biofeedback entirely, so benefit-plan coverage must be checked.

Policy CPB 0132 · Effective · Verify against the current Aetna policy before submitting — view source policy.

Payer

Aetna

Policy

CPB 0132

Prior auth

Confirm

Effective

January 1, 2026

This page reflects the coverage criteria captured from Aetna policy CPB 0132 and may not include every criterion, exception, or code — verify the complete bulletin before submitting.

What this means for the claim

The covered path, the next step to get it approved, and the specific way it denies — built only from this policy.

When does Aetna cover Biofeedback (CPT 90875), and what gets it denied?

Path
Aetna covers biofeedback as medically necessary for a defined set of indications — cancer pain, chronic constipation due to dyssynergic defecation (confirmed by anorectal manometry), fecal incontinence, irritable bowel syndrome, levator ani syndrome, migraine and tension headaches (EMG/skin/thermal only, not EEG), neuromuscular rehab after stroke/TBI, refractory severe subjective tinnitus, TMJ syndrome, and urinary incontinence. All other uses (60+ conditions, plus EEG biofeedback for headache and any home biofeedback) are considered experimental/investigational, and using biofeedback in non-diseased persons for wellness is not medically necessary. Some plans exclude biofeedback entirely, so benefit-plan coverage must be checked. Coverage criteria include: Biofeedback is considered medically necessary for cancer pain; Biofeedback is considered medically necessary for chronic constipation — ONLY when secondary to dyssynergic defecation as confirmed by anorectal manometry; Biofeedback is considered medically necessary for fecal incontinence; Biofeedback is considered medically necessary for irritable bowel syndrome; Biofeedback is considered medically necessary for levator ani syndrome (also known as anorectal pain syndrome); Biofeedback is considered medically necessary for migraine and tension headaches — RESTRICTED to muscle (EMG), skin, or thermal biofeedback ONLY (EEG biofeedback is experimental/investigational/unproven for this indication); Biofeedback is considered medically necessary for neuromuscular rehabilitation of stroke and traumatic brain injury (TBI); Biofeedback is considered medically necessary for refractory severe subjective tinnitus; Biofeedback is considered medically necessary for temporomandibular joint (TMJ) syndrome; Biofeedback is considered medically necessary for urinary incontinence. Applies to 5 codes: 90875, 90876, 90901, 90912, 90913.
Action
Confirm prior-authorization status with Aetna before scheduling — it is code- and plan-specific, and this policy is not an exact authorization source. Documentation: For chronic constipation: dyssynergic defecation must be confirmed by anorectal manometry.
Trap
Policy exclusions and limitations: Some Aetna plans exclude coverage of biofeedback (check benefit plan descriptions for details) — plan-level benefit exclusion; Not medically necessary: biofeedback as treatment of disease when used for improving emotional and physical health in non-diseased persons; EEG biofeedback for migraine and tension headaches — experimental, investigational, or unproven (effectiveness for this indication not established); AutoMove AM800 for neuromuscular rehabilitation of post-stroke patients — experimental/investigational/unproven (effectiveness not established); Movement pattern biofeedback training after total knee arthroplasty — experimental/investigational/unproven; HeartMath HRV Biofeedback system for the management of headaches — experimental/investigational/unproven; InTandem (rhythmic auditory stimulation/neuro-rehabilitation) for improvement of walking and ambulation in adults with chronic stroke — experimental/investigational/unproven; Postural strapping retraining biofeedback — experimental/investigational/unproven; Surface electromyography biofeedback for chronic ankle instability — experimental/investigational/unproven; Wearable devices for biofeedback rehabilitation of gait disorders in persons with neurological diseases — experimental/investigational/unproven; Biofeedback for abdomino-phrenic dyssynergia — experimental/investigational/unproven; Biofeedback for aging-associated cognitive decline — experimental/investigational/unproven; Biofeedback for allergy — experimental/investigational/unproven; Biofeedback for anger management — experimental/investigational/unproven; Biofeedback for anxiety disorders — experimental/investigational/unproven; Biofeedback as a rehabilitation modality for spasmodic torticollis, spinal cord injury, or following knee surgeries — experimental/investigational/unproven; Biofeedback for asthma — experimental/investigational/unproven; Biofeedback for attention deficit hyperactivity disorder (ADHD) — experimental/investigational/unproven; Biofeedback for autism — experimental/investigational/unproven; Biofeedback for awake bruxism — experimental/investigational/unproven; Biofeedback for balance training (with tongue-placed electrotactile biofeedback or visual interactive biofeedback) — experimental/investigational/unproven; Biofeedback for Bell's palsy (idiopathic facial paralysis) — experimental/investigational/unproven; Biofeedback for cardiovascular diseases (e.g., heart failure) — experimental/investigational/unproven; Biofeedback for chemotherapy-induced peripheral neuropathy — experimental/investigational/unproven; Biofeedback for childhood apraxia of speech — experimental/investigational/unproven; Biofeedback for chronic abacterial prostatitis — experimental/investigational/unproven; Biofeedback for chronic fatigue syndrome — experimental/investigational/unproven; Biofeedback for chronic pain (e.g., back pain, fibromyalgia, neck pain) other than migraine and tension headache — experimental/investigational/unproven; Biofeedback for cleft palate speech (nasopharyngoscopic biofeedback) — experimental/investigational/unproven; Biofeedback for daytime syndrome of urinary frequency — experimental/investigational/unproven; Biofeedback for depression — experimental/investigational/unproven; Biofeedback for developmental speech sound disorders — experimental/investigational/unproven; Biofeedback for diabetes — experimental/investigational/unproven; Biofeedback for epilepsy — experimental/investigational/unproven; Biofeedback for essential hypertension (e.g., by means of the RESPeRATE Device) — experimental/investigational/unproven; Biofeedback for facial pain — experimental/investigational/unproven; Biofeedback for functional dysphonia — experimental/investigational/unproven; Biofeedback for gait rehabilitation of individuals with lower-limb amputation — experimental/investigational/unproven; Home biofeedback (for any indication) — experimental/investigational/unproven; Biofeedback for improvement of anorectal/bowel functions after sphincter-saving surgery for rectal cancer — experimental/investigational/unproven; Biofeedback for improvement of rage attacks in individuals with Tourette syndrome — experimental/investigational/unproven; Biofeedback for improvement of swallowing in persons with dysphagia — experimental/investigational/unproven; Biofeedback for insomnia — experimental/investigational/unproven; Biofeedback for labor pain — experimental/investigational/unproven; Biofeedback for motor function recovery after peripheral nerve injury — experimental/investigational/unproven; Biofeedback for neurogenic bladder — experimental/investigational/unproven; Biofeedback for non-neuropathic voiding disorders — experimental/investigational/unproven; Biofeedback for obsessive-compulsive and related disorders (e.g., body dysmorphic disorder, excoriation/skin-picking disorder, hair-pulling/trichotillomania, and hoarding) — experimental/investigational/unproven; Biofeedback for ordinary muscle tension states — experimental/investigational/unproven; Biofeedback for pain associated with multiple sclerosis — experimental/investigational/unproven; Biofeedback for panic disorders (e.g., FreeSpira breathing system) — experimental/investigational/unproven; Biofeedback for pelvic floor dysfunction — experimental/investigational/unproven; Biofeedback for peripheral arterial disease (e.g., intermittent claudication) — experimental/investigational/unproven; Biofeedback for pre-term labor — experimental/investigational/unproven; Biofeedback for prophylaxis of medication overuse headache and pediatric migraine — experimental/investigational/unproven; Biofeedback for post-traumatic stress disorder — experimental/investigational/unproven; Biofeedback for psychosis — experimental/investigational/unproven; Biofeedback for psychosomatic conditions — experimental/investigational/unproven; Biofeedback for Raynaud's disease/phenomenon — experimental/investigational/unproven; Biofeedback for shoulder instability or pain — experimental/investigational/unproven; Biofeedback for sleep bruxism — experimental/investigational/unproven; Biofeedback for smoking cessation — experimental/investigational/unproven; Biofeedback for somatic symptom disorder — experimental/investigational/unproven; Biofeedback for spasticity secondary to cerebral palsy — experimental/investigational/unproven; Biofeedback for substance use disorders (including use of alcohol, internet, opioid; and gambling) — experimental/investigational/unproven; Biofeedback for toe-out gait modification/retraining in people with knee osteoarthritis — experimental/investigational/unproven; Biofeedback for Tourette's syndrome — experimental/investigational/unproven; Biofeedback for treatment of food/substance craving — experimental/investigational/unproven; Biofeedback for tremor — experimental/investigational/unproven; Biofeedback for Type 2 diabetes — experimental/investigational/unproven; Biofeedback for urinary retention — experimental/investigational/unproven; Biofeedback for vaginal tear — experimental/investigational/unproven; Biofeedback for vaginismus — experimental/investigational/unproven; Biofeedback for vertigo/disequilibrium — experimental/investigational/unproven; Biofeedback for visual disorders — experimental/investigational/unproven; Biofeedback for vulvodynia — experimental/investigational/unproven. Claims may be denied when the requested service falls under these.

Source: Aetna CPB 0132 — Biofeedback

Coverage criteria

  • Biofeedback is considered medically necessary for cancer pain
  • Biofeedback is considered medically necessary for chronic constipation — ONLY when secondary to dyssynergic defecation as confirmed by anorectal manometry
  • Biofeedback is considered medically necessary for fecal incontinence
  • Biofeedback is considered medically necessary for irritable bowel syndrome
  • Biofeedback is considered medically necessary for levator ani syndrome (also known as anorectal pain syndrome)
  • Biofeedback is considered medically necessary for migraine and tension headaches — RESTRICTED to muscle (EMG), skin, or thermal biofeedback ONLY (EEG biofeedback is experimental/investigational/unproven for this indication)
  • Biofeedback is considered medically necessary for neuromuscular rehabilitation of stroke and traumatic brain injury (TBI)
  • Biofeedback is considered medically necessary for refractory severe subjective tinnitus
  • Biofeedback is considered medically necessary for temporomandibular joint (TMJ) syndrome
  • Biofeedback is considered medically necessary for urinary incontinence

Covered codes

Codes listed in this Aetna policy. Check each one's prior-authorization verdict and Medicare rate:

Documentation required

  • For chronic constipation: dyssynergic defecation must be confirmed by anorectal manometry

Frequently asked questions

When does Aetna cover Biofeedback (CPT 90875), and what gets it denied?
Aetna covers biofeedback as medically necessary for a defined set of indications — cancer pain, chronic constipation due to dyssynergic defecation (confirmed by anorectal manometry), fecal incontinence, irritable bowel syndrome, levator ani syndrome, migraine and tension headaches (EMG/skin/thermal only, not EEG), neuromuscular rehab after stroke/TBI, refractory severe subjective tinnitus, TMJ syndrome, and urinary incontinence. All other uses (60+ conditions, plus EEG biofeedback for headache and any home biofeedback) are considered experimental/investigational, and using biofeedback in non-diseased persons for wellness is not medically necessary. Some plans exclude biofeedback entirely, so benefit-plan coverage must be checked. Coverage criteria include: Biofeedback is considered medically necessary for cancer pain; Biofeedback is considered medically necessary for chronic constipation — ONLY when secondary to dyssynergic defecation as confirmed by anorectal manometry; Biofeedback is considered medically necessary for fecal incontinence; Biofeedback is considered medically necessary for irritable bowel syndrome; Biofeedback is considered medically necessary for levator ani syndrome (also known as anorectal pain syndrome); Biofeedback is considered medically necessary for migraine and tension headaches — RESTRICTED to muscle (EMG), skin, or thermal biofeedback ONLY (EEG biofeedback is experimental/investigational/unproven for this indication); Biofeedback is considered medically necessary for neuromuscular rehabilitation of stroke and traumatic brain injury (TBI); Biofeedback is considered medically necessary for refractory severe subjective tinnitus; Biofeedback is considered medically necessary for temporomandibular joint (TMJ) syndrome; Biofeedback is considered medically necessary for urinary incontinence. Applies to 5 codes: 90875, 90876, 90901, 90912, 90913. Confirm prior-authorization status with Aetna before scheduling — it is code- and plan-specific, and this policy is not an exact authorization source. Documentation: For chronic constipation: dyssynergic defecation must be confirmed by anorectal manometry. Policy exclusions and limitations: Some Aetna plans exclude coverage of biofeedback (check benefit plan descriptions for details) — plan-level benefit exclusion; Not medically necessary: biofeedback as treatment of disease when used for improving emotional and physical health in non-diseased persons; EEG biofeedback for migraine and tension headaches — experimental, investigational, or unproven (effectiveness for this indication not established); AutoMove AM800 for neuromuscular rehabilitation of post-stroke patients — experimental/investigational/unproven (effectiveness not established); Movement pattern biofeedback training after total knee arthroplasty — experimental/investigational/unproven; HeartMath HRV Biofeedback system for the management of headaches — experimental/investigational/unproven; InTandem (rhythmic auditory stimulation/neuro-rehabilitation) for improvement of walking and ambulation in adults with chronic stroke — experimental/investigational/unproven; Postural strapping retraining biofeedback — experimental/investigational/unproven; Surface electromyography biofeedback for chronic ankle instability — experimental/investigational/unproven; Wearable devices for biofeedback rehabilitation of gait disorders in persons with neurological diseases — experimental/investigational/unproven; Biofeedback for abdomino-phrenic dyssynergia — experimental/investigational/unproven; Biofeedback for aging-associated cognitive decline — experimental/investigational/unproven; Biofeedback for allergy — experimental/investigational/unproven; Biofeedback for anger management — experimental/investigational/unproven; Biofeedback for anxiety disorders — experimental/investigational/unproven; Biofeedback as a rehabilitation modality for spasmodic torticollis, spinal cord injury, or following knee surgeries — experimental/investigational/unproven; Biofeedback for asthma — experimental/investigational/unproven; Biofeedback for attention deficit hyperactivity disorder (ADHD) — experimental/investigational/unproven; Biofeedback for autism — experimental/investigational/unproven; Biofeedback for awake bruxism — experimental/investigational/unproven; Biofeedback for balance training (with tongue-placed electrotactile biofeedback or visual interactive biofeedback) — experimental/investigational/unproven; Biofeedback for Bell's palsy (idiopathic facial paralysis) — experimental/investigational/unproven; Biofeedback for cardiovascular diseases (e.g., heart failure) — experimental/investigational/unproven; Biofeedback for chemotherapy-induced peripheral neuropathy — experimental/investigational/unproven; Biofeedback for childhood apraxia of speech — experimental/investigational/unproven; Biofeedback for chronic abacterial prostatitis — experimental/investigational/unproven; Biofeedback for chronic fatigue syndrome — experimental/investigational/unproven; Biofeedback for chronic pain (e.g., back pain, fibromyalgia, neck pain) other than migraine and tension headache — experimental/investigational/unproven; Biofeedback for cleft palate speech (nasopharyngoscopic biofeedback) — experimental/investigational/unproven; Biofeedback for daytime syndrome of urinary frequency — experimental/investigational/unproven; Biofeedback for depression — experimental/investigational/unproven; Biofeedback for developmental speech sound disorders — experimental/investigational/unproven; Biofeedback for diabetes — experimental/investigational/unproven; Biofeedback for epilepsy — experimental/investigational/unproven; Biofeedback for essential hypertension (e.g., by means of the RESPeRATE Device) — experimental/investigational/unproven; Biofeedback for facial pain — experimental/investigational/unproven; Biofeedback for functional dysphonia — experimental/investigational/unproven; Biofeedback for gait rehabilitation of individuals with lower-limb amputation — experimental/investigational/unproven; Home biofeedback (for any indication) — experimental/investigational/unproven; Biofeedback for improvement of anorectal/bowel functions after sphincter-saving surgery for rectal cancer — experimental/investigational/unproven; Biofeedback for improvement of rage attacks in individuals with Tourette syndrome — experimental/investigational/unproven; Biofeedback for improvement of swallowing in persons with dysphagia — experimental/investigational/unproven; Biofeedback for insomnia — experimental/investigational/unproven; Biofeedback for labor pain — experimental/investigational/unproven; Biofeedback for motor function recovery after peripheral nerve injury — experimental/investigational/unproven; Biofeedback for neurogenic bladder — experimental/investigational/unproven; Biofeedback for non-neuropathic voiding disorders — experimental/investigational/unproven; Biofeedback for obsessive-compulsive and related disorders (e.g., body dysmorphic disorder, excoriation/skin-picking disorder, hair-pulling/trichotillomania, and hoarding) — experimental/investigational/unproven; Biofeedback for ordinary muscle tension states — experimental/investigational/unproven; Biofeedback for pain associated with multiple sclerosis — experimental/investigational/unproven; Biofeedback for panic disorders (e.g., FreeSpira breathing system) — experimental/investigational/unproven; Biofeedback for pelvic floor dysfunction — experimental/investigational/unproven; Biofeedback for peripheral arterial disease (e.g., intermittent claudication) — experimental/investigational/unproven; Biofeedback for pre-term labor — experimental/investigational/unproven; Biofeedback for prophylaxis of medication overuse headache and pediatric migraine — experimental/investigational/unproven; Biofeedback for post-traumatic stress disorder — experimental/investigational/unproven; Biofeedback for psychosis — experimental/investigational/unproven; Biofeedback for psychosomatic conditions — experimental/investigational/unproven; Biofeedback for Raynaud's disease/phenomenon — experimental/investigational/unproven; Biofeedback for shoulder instability or pain — experimental/investigational/unproven; Biofeedback for sleep bruxism — experimental/investigational/unproven; Biofeedback for smoking cessation — experimental/investigational/unproven; Biofeedback for somatic symptom disorder — experimental/investigational/unproven; Biofeedback for spasticity secondary to cerebral palsy — experimental/investigational/unproven; Biofeedback for substance use disorders (including use of alcohol, internet, opioid; and gambling) — experimental/investigational/unproven; Biofeedback for toe-out gait modification/retraining in people with knee osteoarthritis — experimental/investigational/unproven; Biofeedback for Tourette's syndrome — experimental/investigational/unproven; Biofeedback for treatment of food/substance craving — experimental/investigational/unproven; Biofeedback for tremor — experimental/investigational/unproven; Biofeedback for Type 2 diabetes — experimental/investigational/unproven; Biofeedback for urinary retention — experimental/investigational/unproven; Biofeedback for vaginal tear — experimental/investigational/unproven; Biofeedback for vaginismus — experimental/investigational/unproven; Biofeedback for vertigo/disequilibrium — experimental/investigational/unproven; Biofeedback for visual disorders — experimental/investigational/unproven; Biofeedback for vulvodynia — experimental/investigational/unproven. Claims may be denied when the requested service falls under these.
Does Aetna require prior authorization for Biofeedback?
Confirm prior-authorization status with Aetna before scheduling — it is code- and plan-specific, and this policy is not an exact authorization source. Documentation: For chronic constipation: dyssynergic defecation must be confirmed by anorectal manometry.
What does Aetna exclude for Biofeedback?
Policy exclusions and limitations: Some Aetna plans exclude coverage of biofeedback (check benefit plan descriptions for details) — plan-level benefit exclusion; Not medically necessary: biofeedback as treatment of disease when used for improving emotional and physical health in non-diseased persons; EEG biofeedback for migraine and tension headaches — experimental, investigational, or unproven (effectiveness for this indication not established); AutoMove AM800 for neuromuscular rehabilitation of post-stroke patients — experimental/investigational/unproven (effectiveness not established); Movement pattern biofeedback training after total knee arthroplasty — experimental/investigational/unproven; HeartMath HRV Biofeedback system for the management of headaches — experimental/investigational/unproven; InTandem (rhythmic auditory stimulation/neuro-rehabilitation) for improvement of walking and ambulation in adults with chronic stroke — experimental/investigational/unproven; Postural strapping retraining biofeedback — experimental/investigational/unproven; Surface electromyography biofeedback for chronic ankle instability — experimental/investigational/unproven; Wearable devices for biofeedback rehabilitation of gait disorders in persons with neurological diseases — experimental/investigational/unproven; Biofeedback for abdomino-phrenic dyssynergia — experimental/investigational/unproven; Biofeedback for aging-associated cognitive decline — experimental/investigational/unproven; Biofeedback for allergy — experimental/investigational/unproven; Biofeedback for anger management — experimental/investigational/unproven; Biofeedback for anxiety disorders — experimental/investigational/unproven; Biofeedback as a rehabilitation modality for spasmodic torticollis, spinal cord injury, or following knee surgeries — experimental/investigational/unproven; Biofeedback for asthma — experimental/investigational/unproven; Biofeedback for attention deficit hyperactivity disorder (ADHD) — experimental/investigational/unproven; Biofeedback for autism — experimental/investigational/unproven; Biofeedback for awake bruxism — experimental/investigational/unproven; Biofeedback for balance training (with tongue-placed electrotactile biofeedback or visual interactive biofeedback) — experimental/investigational/unproven; Biofeedback for Bell's palsy (idiopathic facial paralysis) — experimental/investigational/unproven; Biofeedback for cardiovascular diseases (e.g., heart failure) — experimental/investigational/unproven; Biofeedback for chemotherapy-induced peripheral neuropathy — experimental/investigational/unproven; Biofeedback for childhood apraxia of speech — experimental/investigational/unproven; Biofeedback for chronic abacterial prostatitis — experimental/investigational/unproven; Biofeedback for chronic fatigue syndrome — experimental/investigational/unproven; Biofeedback for chronic pain (e.g., back pain, fibromyalgia, neck pain) other than migraine and tension headache — experimental/investigational/unproven; Biofeedback for cleft palate speech (nasopharyngoscopic biofeedback) — experimental/investigational/unproven; Biofeedback for daytime syndrome of urinary frequency — experimental/investigational/unproven; Biofeedback for depression — experimental/investigational/unproven; Biofeedback for developmental speech sound disorders — experimental/investigational/unproven; Biofeedback for diabetes — experimental/investigational/unproven; Biofeedback for epilepsy — experimental/investigational/unproven; Biofeedback for essential hypertension (e.g., by means of the RESPeRATE Device) — experimental/investigational/unproven; Biofeedback for facial pain — experimental/investigational/unproven; Biofeedback for functional dysphonia — experimental/investigational/unproven; Biofeedback for gait rehabilitation of individuals with lower-limb amputation — experimental/investigational/unproven; Home biofeedback (for any indication) — experimental/investigational/unproven; Biofeedback for improvement of anorectal/bowel functions after sphincter-saving surgery for rectal cancer — experimental/investigational/unproven; Biofeedback for improvement of rage attacks in individuals with Tourette syndrome — experimental/investigational/unproven; Biofeedback for improvement of swallowing in persons with dysphagia — experimental/investigational/unproven; Biofeedback for insomnia — experimental/investigational/unproven; Biofeedback for labor pain — experimental/investigational/unproven; Biofeedback for motor function recovery after peripheral nerve injury — experimental/investigational/unproven; Biofeedback for neurogenic bladder — experimental/investigational/unproven; Biofeedback for non-neuropathic voiding disorders — experimental/investigational/unproven; Biofeedback for obsessive-compulsive and related disorders (e.g., body dysmorphic disorder, excoriation/skin-picking disorder, hair-pulling/trichotillomania, and hoarding) — experimental/investigational/unproven; Biofeedback for ordinary muscle tension states — experimental/investigational/unproven; Biofeedback for pain associated with multiple sclerosis — experimental/investigational/unproven; Biofeedback for panic disorders (e.g., FreeSpira breathing system) — experimental/investigational/unproven; Biofeedback for pelvic floor dysfunction — experimental/investigational/unproven; Biofeedback for peripheral arterial disease (e.g., intermittent claudication) — experimental/investigational/unproven; Biofeedback for pre-term labor — experimental/investigational/unproven; Biofeedback for prophylaxis of medication overuse headache and pediatric migraine — experimental/investigational/unproven; Biofeedback for post-traumatic stress disorder — experimental/investigational/unproven; Biofeedback for psychosis — experimental/investigational/unproven; Biofeedback for psychosomatic conditions — experimental/investigational/unproven; Biofeedback for Raynaud's disease/phenomenon — experimental/investigational/unproven; Biofeedback for shoulder instability or pain — experimental/investigational/unproven; Biofeedback for sleep bruxism — experimental/investigational/unproven; Biofeedback for smoking cessation — experimental/investigational/unproven; Biofeedback for somatic symptom disorder — experimental/investigational/unproven; Biofeedback for spasticity secondary to cerebral palsy — experimental/investigational/unproven; Biofeedback for substance use disorders (including use of alcohol, internet, opioid; and gambling) — experimental/investigational/unproven; Biofeedback for toe-out gait modification/retraining in people with knee osteoarthritis — experimental/investigational/unproven; Biofeedback for Tourette's syndrome — experimental/investigational/unproven; Biofeedback for treatment of food/substance craving — experimental/investigational/unproven; Biofeedback for tremor — experimental/investigational/unproven; Biofeedback for Type 2 diabetes — experimental/investigational/unproven; Biofeedback for urinary retention — experimental/investigational/unproven; Biofeedback for vaginal tear — experimental/investigational/unproven; Biofeedback for vaginismus — experimental/investigational/unproven; Biofeedback for vertigo/disequilibrium — experimental/investigational/unproven; Biofeedback for visual disorders — experimental/investigational/unproven; Biofeedback for vulvodynia — experimental/investigational/unproven. Claims may be denied when the requested service falls under these.

Source

Aetna CPB 0132 — Biofeedback

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Coverage disclaimer

This page summarizes Aetna clinical-coverage criteria extracted from policy CPB 0132 for educational purposes. Coverage policies change and vary by individual plan. Always verify against Aetna's current policy before performing a procedure or submitting a claim. d3rx is not responsible for claim denials or reimbursement issues.