`E0721` Trans elec stim auricular

Transcutaneous electrical nerve stimulator for nerves in the auricular region

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

DME supplier: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction

Payer policies and prior authorization for E0721

15 of 15 payer prior-auth lists that name E0721 require prior authorization or set conditions: CarePlus Health Plans, Cigna, Humana.

Payer	Plan	State	Prior auth	Conditions	Since	Source
Cigna	ACA/IFP	All	prior auth required	May be delegated to eviCore for some clients	Oct 1, 2024	Master Precertification List (For Health Care Providers)
Cigna	Basic Standard	All	prior auth required	May be delegated to eviCore for some clients	Oct 1, 2024	Master Precertification List (For Health Care Providers)
Cigna	Complete/PHS+/Preferred	All	prior auth required	May be delegated to eviCore for some clients	Oct 1, 2024	Master Precertification List (For Health Care Providers)
Cigna	Durable Medical Equipment	All	prior auth required	Experimental/investigational	Mar 7, 2026	Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs
Cigna	Durable Medical Equipment	All	prior auth required	Experimental/investigational; Intake only if requested as SAR Payer	Mar 7, 2026	Cigna Commercial Prior Authorization Procedure Code List: Durable Medical Equipment
CarePlus Health Plans	CarePlus Health Plans	FL	prior auth required		Jan 1, 2027	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
Humana	Humana D-SNP (FL)	FL	prior auth required		Jan 1, 2027	1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List
Humana	Humana D-SNP (IL)	IL	prior auth required		Jan 1, 2027	Humana Dual Fully Integrated Illinois Prior Authorization and Notification List
Humana	Humana D-SNP (IN)	IN	prior auth required		Jan 1, 2027	*New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List
Humana	Humana D-SNP (MI)	MI	prior auth required		Jan 1, 2027	1 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List
Humana	Humana D-SNP (SC)	SC	prior auth required		Jan 1, 2027	Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List
Humana	Humana D-SNP (VA)	VA	prior auth required		Jan 1, 2027	Virginia Prior Authorization and Notification List
Humana	Humana MA and D-SNP	All	prior auth required		Jan 1, 2027	Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
Humana	Humana Puerto Rico MA and Dual Medicare-Medicaid	PR	prior auth required		Nov 3, 2025	Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification
Humana	Oak Street Health	All	prior auth required			Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management

Payer coverage policies that name E0721

E0721 appears in 19 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross, Regence, UnitedHealthcare.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Electrical Stimulation for Nausea, Vomiting, Motion Sickness and Other Selected Indications (0676)	not covered	Oct 7, 2026	payer document
Anthem	Percutaneous Electrical Nerve Field Stimulation (PENFS) (CG-MED-104)	not covered	Nov 6, 2025	payer document
Blue Cross & Blue Shield of Mississippi	Cranial Electrotherapy Stimulation Ces And Auricular Electrostimulation	unproven / investigational		payer document
Blue Cross & Blue Shield of Rhode Island	Cranial Electrotherapy Stimulation and Auricular Electrostimulation	not covered	May 6, 2026	payer document
Blue Cross Blue Shield of Massachusetts	Cranial Electrotherapy Stimulation and Auricular Electrostimulation (362)	unproven / investigational		payer document
BlueCross BlueShield of South Carolina	Transcutaneous Electrical Nerve Stimulation and Transcutaneous Afferent Patterned Stimulation (CAM 10109)	listed, no stance (range E0720-E0731)	Feb 1, 2026	payer document
Cigna	Electrical Stimulation Therapy and Devices in a Home Setting (0160)	unproven / investigational	Sep 15, 2026	payer document
Premera Blue Cross	Cranial Electrotherapy Stimulation and Auricular Electrostimulation (8.01.540)	listed, no stance	Jun 8, 2026	payer document
Regence	Auricular Electrostimulation (Medicine 146)	listed, no stance	Apr 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (2026T0126UU)	listed, no stance	Mar 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (CS036.Y)	listed, no stance	May 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Idaho Only) (CS036ID.D)	listed, no stance	Jun 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Kansas Only) (CS036KS.02)	listed, no stance	May 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Kentucky Only) (CS036KY.12)	listed, no stance	May 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Nebraska Only) (CS036NE.U)	listed, no stance	May 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for New Mexico Only) (CS036NM.D)	listed, no stance	May 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Ohio Only) (CS036OH.F)	listed, no stance	May 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Pennsylvania Only) (CS036PA.W)	listed, no stance	May 1, 2026	payer document
UnitedHealthcare	Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation (for Tennessee Only) (CS036TN.Y)	listed, no stance	May 1, 2026	payer document

Recent prior-auth changes

Oct 8, 2024: PA added, humana:pa:commercial

Medicaid fee-for-service

Prior authorization required or conditional in CO, IN, MS, OH, VT.

CO: $100.25 (chp_plus, non-facility), effective Jul 1, 2026
KS: $53.99 (default), effective Oct 1, 2024
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

E0721 Trans elec stim auricular