`E0737` Transcut tibial stim by app

Transcutaneous tibial nerve stimulator, controlled by phone application

Medicare coverage: Non-covered by statute
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 E0737

10 of 10 payer prior-auth lists that name E0737 require prior authorization or set conditions: CarePlus Health Plans, Humana.

Payer	Plan	State	Prior auth	Since	Source
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 E0737

E0737 appears in 7 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Shield of California, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Urinary Incontinence (0223)	not covered	Jul 16, 2026	payer document
Anthem	Tibial Nerve Stimulation (CG-SURG-126)	not covered	Feb 19, 2026	payer document
Blue Cross & Blue Shield of Mississippi	Tibial Nerve Stimulation (A.7.01.106)	unproven / investigational		payer document
Blue Cross & Blue Shield of Mississippi	Transcutaneous Electrical Nerve Stimulator Tens (L.1.01.408)	unproven / investigational		payer document
Blue Shield of California	\| Tibial Nerve Stimulation (7.01.106)	listed, no stance		payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)	Tibial Nerve Stimulation (MED205.035) CPT Codes 64566, 64999, 0587T, 0588T, 0589T, 0590T, 0816T, 0818T	listed, no stance	Jan 1, 2026	payer document
Premera Blue Cross	Electrical Stimulation Devices (1.01.507)	listed, no stance	Feb 10, 2026	payer document

Recent prior-auth changes

Dec 10, 2024: PA added, humana:pa:commercial
Oct 31, 2024: PA removed, Cigna
Oct 31, 2024: PA removed, Cigna

Medicaid fee-for-service

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

CO: $183.62 (chp_plus, non-facility), effective Jul 1, 2026
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.

E0737 Transcut tibial stim by app