A transcutaneous electrical nerve stimulator (TENS) is a device that uses electrical current delivered through electrodes placed on the skin to decrease a recipient’s perception of pain by inhibiting the transmission of pain nerve impulses toward the brain and. stimulating the release of endorphins.
The following providers may provide TENS units and related supplies:
Clinical nurse specialist
Federally qualified health centers
Home health agencies
Indian Health Services
Rural health clinics
Providers must meet any provider criteria, including accreditation, for third party insurance or for Medicare in order to assist recipients for whom MHCP is not the primary payer.
For eligible recipients with acute pain, MHCP covers rental of a TENS device.
For eligible recipients with chronic pain other than low back pain, MHCP covers either purchase or rental of a TENS device.
Codes: E0720, E0730, E0731, A4557, A4595
Only TENS devices and conductive garments approved by the Food and Drug Administration (FDA) are covered.
One set of 2-lead TENS supplies is covered each month of use for recipients using a 2-lead (E0720) TENS device.
Two sets of 2-lead TENS supplies are covered each month of use for recipients using a 4-lead (E0730) TENS device. TENS supplies necessary for use of the TENS device for one month include, but are not limited to:
Replacement lead wires are covered no more than twice per year.
Suppliers must verify the TENS device is still being used before dispensing TENS supplies or lead wires. A new order is not required unless the original order had an end date.
TENS is not medically necessary for the treatment of chronic low back pain, defined as low back pain from any cause lasting six weeks or more.
Supplies other than listed above for use with the TENS device are not covered.
Refer to the following authorization requirements:
Submit authorization requests through MN–ITS (authorization request 278). Fax the MN–ITS response with the required documentation and physician’s order to the authorization medical review agent. Document the MN–ITS Authorization Request number assigned on every page of each document.
For paper authorization, fax or mail the authorization medical review agent the required documentation, physician’s orders and the completed MHCP Authorization Form (DHS-4695-ENG) (PDF).
When billing with an approved authorization:
Minnesota Statutes 256B.0625, subd.31
Minnesota Rules 9505.0310