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Requirements for Neurostimulators and Neuromuscular Stimulators Procedure Code A4560

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

Effective for dates of service on or after July 1, 2023, neuromuscular electrical stimulator and transcutaneous electrical stimulation supply procedure code A4560 will require prior authorization and will be limited to one unit every 12 weeks or four units per year.

For more information, call the TMHP Contact Center at 800-925-9126.