Does Medicare cover TENS units?

When does Medicare cover a TENS unit?

Under the coverage policy Medicare's equipment contractors use, Medicare covers a TENS unit, a device that sends electrical current through electrodes on the surface of your skin to lessen how much pain you feel, in two situations. The practitioner who orders it must be the treating practitioner for the condition that needs it.

• Acute pain after surgery: TENS is covered for post-operative pain, limited to 30 days (one month's rental) from the day of surgery, and paid only as a rental.
• Chronic, intractable pain other than chronic low back pain, when all of these are true: the presumed cause of the pain is a type accepted as responding to TENS therapy; the pain has been present for at least three months; and other appropriate treatments have been tried and failed.

Which kinds of pain aren't covered?

Medicare denies a TENS unit for acute pain (lasting less than three months) other than pain after surgery, and for chronic pain that doesn't meet the criteria. The coverage policy Medicare's equipment contractors use gives headache, visceral abdominal pain, pelvic pain and temporomandibular joint (TMJ) pain as examples of conditions for which TENS therapy isn't considered reasonable and necessary.

TENS for chronic low back pain isn't covered. CMS's national coverage determination says TENS is not reasonable and necessary for chronic low back pain, which it defines as low back pain that has lasted three months or longer and isn't a symptom of a clearly defined primary disease, such as a cancer that has spread to the spine. CMS's 2012 decision allowed coverage only for people enrolled in an approved clinical study, and that study coverage was set to expire three years after the decision was published. See what Medicare covers for pain management.

How does the TENS trial period work?

For chronic pain, the equipment contractors' policy requires you to use the TENS unit on a trial basis for at least one month (30 days) but no more than two months, and Medicare pays for the trial as a rental. Your treating practitioner monitors the trial to see how well the TENS unit controls your pain. For Medicare to cover buying the unit, your practitioner must determine that you're likely to get significant therapeutic benefit from continuous use over a long period.

At the end of the trial, your medical record must show how often you used the TENS unit, how long you typically used it each time, and how well it worked.

What do I pay for a TENS unit and supplies?

After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount for a covered TENS unit, if your supplier accepts assignment. Medicare only pays for DME from suppliers enrolled in Medicare.

While you rent a TENS unit, supplies like electrodes, lead wires and batteries are included in the rental, with no separate payment. If you buy the unit, its payment includes lead wires and one month's supply of items like electrodes, conductive paste or gel, and batteries. After that, Medicare can pay separately for replacement supplies that are reasonable and necessary and used with a covered TENS unit.

Does Medicare cover TENS in a hospital, doctor's office or clinic?

In some cases. When TENS is used for acute pain after surgery, CMS treats the TENS device as a supply: a hospital supply for inpatients under Part A, or a supply incident to a physician's service under Part B when the surgery is done on an outpatient basis. Medicare may also pay for TENS used on a trial basis, monitored by a physician or physical therapist, to decide whether ongoing TENS is likely to help you.

Ongoing electrical nerve stimulation treatments for pain in a doctor's office, by a physical therapist or at an outpatient clinic are excluded from coverage. Once you've been trained to use the stimulator and electrical nerve stimulation is continued as therapy, CMS expects either a stimulator to be implanted or you to use the TENS unit at home.

Does Medicare Advantage or Medigap change TENS coverage?

Medicare Advantage plans must cover the same medically necessary categories of DME as Original Medicare, but the suppliers you use and your costs depend on the plan, and you may need the plan's approval (prior authorization) first. A Medigap policy may help cover some of your costs for covered DME in Original Medicare, like the 20% coinsurance.