S3900 Surface emgSurface electromyography (emg)
Status I: not valid for Medicare (Medicare uses another code).
S3900 appears in 28 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, BlueCross BlueShield of South Carolina, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Chiropractic Services (0107) | listed, no stance | Apr 7, 2026 | payer document |
| Aetna | Intraoperative Neurophysiological Monitoring (0697) | not covered | Jun 19, 2026 | payer document |
| Aetna | Obstructive Sleep Apnea in Children (0752) | not covered | Oct 30, 2025 | payer document |
| Aetna | Spasticity Management (0362) | not covered | May 26, 2026 | payer document |
| Aetna | Surface Scanning and Macro Electromyography (0112) | not covered | Mar 25, 2026 | payer document |
| Anthem | Surface Electromyography and Electrodermal Activity Sensor Devices for Seizure Monitoring (MED.00130) | unproven / investigational | Nov 6, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Electromyography Emg (L.2.01.417) | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Paraspinal Surface Electromyography To Evaluate And Monitor Back Pain | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Temporomandibular Joint Disorder | not covered | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Paraspinal Surface Electromyography (SEMG) to Evaluate and Monitor Back Pain | not covered | May 20, 2026 | payer document |
| Blue Cross Blue Shield of Massachusetts | Paraspinal Surface Electromyography (517) | listed, no stance | payer document | |
| Blue Shield of California | Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain (2.01.35) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain (CAM 20135) 97799 | Unlisted physical medicine/rehabilitation service or procedure | listed, no stance | Oct 1, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Surface Electromyography and Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain (MED205.006) | listed, no stance | Oct 1, 2025 | payer document |
| Premera Blue Cross | Temporomandibular Joint Disorder (2.01.535) Page | 5 of 20 | ∞ | listed, no stance | Apr 13, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (2026T0493II) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (CS082.W) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Idaho Only) (CS082ID.C) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Indiana Only) (CS082IN.10) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Kansas Only) (CS082KS.02) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Kentucky Only) (CS082KY.12) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Nebraska Only) (CS082NE.W) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for New Jersey Only) (CS082NJ.T) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for New Mexico Only) (CS082NM.C) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for North Carolina Only) (CSNCT0152.08) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Ohio Only) (CS082OH.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Pennsylvania Only) (CS082PA.U) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Tennessee Only) (CS082TN.U) | listed, no stance | Apr 1, 2026 | payer document |
Prior authorization required or conditional in IN.
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.