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Transcutaneous Electrical Nerve Stimulation (TENS) Procedure Code E0736 to Become a Benefit for CSHCN Effective June 1, 2024

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Effective for dates of service on or after June 1, 2024, transcutaneous electrical nerve stimulation (TENS) procedure code E0736 will become a Children with Special Health Care Needs (CSHCN) Services Program benefit with prior authorization for clients who are 18 years of age or older.

TENS is a treatment for overactive bladder (OAB). It involves the attachment of a transcutaneous nerve stimulator to the surface of the skin over the peripheral nerve to be stimulated.

TENS will be a benefit for CSHCN limited to clients who meet the following criteria:

  • Have had an evaluation that was performed by an appropriate specialist, usually a urologist or urogynecologist, who determined that the client is a candidate for posterior tibial nerve stimulation (PTNS)
  • Have a medical record that includes the following documentation:
    • The client has been compliant with and has failed a trial of symptom-appropriate behavioral therapy of sufficient length to evaluate potential efficacy.
    • The client has been compliant with and has failed or been unable to tolerate a trial of at least two appropriate medications administered for four to eight weeks.
    • The client’s voiding diary shows continued findings of OAB.
    • The client has documented a willingness to attend in-office treatment sessions, to comply with behavioral therapies, and to continue to keep voiding diaries that include documentation of behavioral therapy compliance.

TENS rental or purchase of devices and conductive garments may be reimbursed when medically necessary and with prior authorization.

For more information, call the TMHP-CSHCN Services Program Contact Center at 800-568-2413.