Frequently asked questions
Short answers, each with its source and a link to the full guide.
TENS basics
What is a TENS unit and how does it work?
A TENS unit is a small, battery-powered device with wires and sticky electrode pads. It passes a weak electrical current through the skin to your nerves to help ease pain. The NHS says it is thought to work by encouraging your body to release natural painkillers called endorphins and by stopping pain messages from reaching your brain. FDA classifies the device as Class II. Ask your clinician if it fits your pain.
Does a TENS unit really work?
It may help some people, and the evidence is uncertain. A 2022 review in Medicina found TENS may have efficacy for a variety of acute and chronic pain conditions, but the size of the effect remains uncertain because the studies are low in quality. The NHS says TENS does not work for everyone. Ask your clinician whether a trial makes sense for you.
Read moreSource: Medicina (2022), PMC, NHS, Cleveland Clinic
How long should I leave a TENS unit on?
Your clinician and your device's instructions set session length, so follow them. University of Iowa Health Care says research shows TENS is most helpful for chronic pain when used for at least 30 minutes while you are active, and less effective when you sit still. Some people use TENS only when pain is worst, and others use it daily. Never use it while sleeping, bathing or driving.
Read moreSource: University of Iowa Health Care, University of Iowa Health Care, University of Iowa Health Care
What settings should I use on my TENS unit?
Follow your clinician's and your device's instructions. For intensity, the NHS says to turn the dial slowly until you feel a tingling sensation that is not painful. University of Iowa Health Care says to make it strong but comfortable. A 2022 review in Medicina says stimulation intensity has been documented as critical to therapeutic success. Frequency and pulse width are also adjustable on many units.
Read moreSource: NHS, University of Iowa Health Care, Medicina (2022), PMC, Cleveland Clinic
Where do I put TENS pads for lower back pain?
Place electrode pads on clean skin near the painful area, with a gap between them, as the NHS advises. University of Iowa Health Care says not to place them directly on your backbone. The NHS says not to use TENS on your chest and back at the same time. Ask your clinician to show you. Medicare's policy denies TENS for chronic low back pain as not reasonable and necessary.
Read moreSource: NHS, University of Iowa Health Care, NHS, CMS
Where do I put TENS pads for sciatica?
Ask your clinician or physical therapist to show you. University of Iowa Health Care says to try to surround the painful area and place pads on fleshy areas of the body, not over bony sites. MedlinePlus says sciatica is a symptom of a problem with the sciatic nerve, so the cause matters. Follow your clinician's and your device's instructions.
Read moreSource: University of Iowa Health Care, MedlinePlus, NHS
Can you use a TENS unit on your neck?
The NHS says do not use TENS on your neck, mouth or eyes. University of Iowa Health Care says not to use it on any part of your head, face or throat. Cleveland Clinic lists the front and side of the neck as places to avoid. If you have neck pain, ask your clinician what is safe for you.
Read moreSource: NHS, University of Iowa Health Care, Cleveland Clinic
Does a TENS unit work for knee pain?
The evidence is mixed. A 2022 review in Medicina says clinical practice guidelines are mixed, and that for knee osteoarthritis and after total knee replacement there are recommendations against TENS use. The review also says the quality of trials limits what we know. Ask your clinician whether TENS fits your knee pain and what else to try.
Read moreSource: Medicina (2022), PMC, Medicina (2022), PMC, Medicina (2022), PMC
Can a TENS unit help a headache?
Medicare's TENS policy lists headache as a condition where TENS is not considered reasonable and necessary, as of the revision effective January 1, 2024. University of Iowa Health Care says not to use TENS on any part of your head or face. If you have headaches, talk with your doctor about the cause and your options.
What is the difference between TENS and EMS?
FDA describes a TENS device as one that applies an electrical current to electrodes on the skin to treat pain. A 2023 study in PMC describes EMS, or electrical muscle stimulation, as activating muscles through electrical currents, which causes involuntary muscle contractions. So TENS is aimed at pain and EMS at muscle activity. Check your device label and ask your clinician which mode to use.
What are other options besides a TENS unit?
CDC says nonopioid therapies are preferred for subacute and chronic pain, and lists exercise, physical therapy methods, mind-body practices and nonopioid medicines as examples. CDC also says nonpharmacologic therapies are not always covered or fully covered by insurance. Talk with your doctor about your options. Do not stop or start any medicine on your own.
Coverage and paperwork
Does Medicare cover a TENS unit?
Sometimes, under set rules. As of the Medicare LCD revision effective January 1, 2024, a TENS unit is covered for chronic, intractable pain or acute post-operative pain when criteria are met. TENS for chronic low back pain and for acute pain other than post-operative pain is denied as not reasonable and necessary. Headache is also listed as not reasonable and necessary. Coverage is never certain, so ask your plan.
Does Medicare cover a TENS unit for back pain?
For chronic low back pain, no. The Medicare TENS policy says TENS therapy for chronic low back pain will be denied as not reasonable and necessary, as of the LCD revision effective January 1, 2024. CMS first limited coverage to approved clinical studies for dates of service on or after June 8, 2012. Talk with your doctor about other options.
Does Medicare cover TENS supplies and electrodes?
It depends on rental or purchase. The CMS policy article says that during the rental of a TENS unit, supplies are included in the rental allowance. For a covered unit, the LCD allows separate payment for replacement supplies when reasonable and necessary, with a usual maximum that depends on whether the unit uses 2 or 4 leads. This is as of the revision effective January 1, 2024.
Does insurance cover a TENS unit?
It depends on your plan. University of Iowa Health Care says TENS units are not routinely covered by insurance, but all companies have different policies, and it advises you to call your insurance company. Ask your plan whether it covers a TENS unit, which supplier to use, and what paperwork your clinician must complete.
How do I get a TENS unit covered by insurance?
Start with your clinician, then ask your plan. Medicare's TENS policy says the ordering practitioner must be the treating practitioner for the condition. Some plans need approval first. Medicare.gov says a Medicare Advantage plan may require prior authorization for certain services. Ask your plan about its rules, then have your clinician send what the plan asks for.
Read moreSource: CMS, Medicare.gov, University of Iowa Health Care
How do I get a TENS unit from the VA?
Check with your VA health care team. VA says to be eligible for its Prosthetic and Sensory Aids Service, you must be enrolled in VA health care and have a medical need or a referral from a provider for a prosthetic service or device. Additional criteria may apply. This page does not say whether a TENS unit is included, so ask your VA team.
Read moreSource: VA Butler Health Care, VA Butler Health Care
Do you need a prescription for a TENS unit?
It depends on the model and who pays. For Medicare, the LCD requires that the ordering practitioner be the treating practitioner for the condition. FDA rules require prescription devices to carry an Rx only label. The NHS says some TENS machines are sold online and in shops. Check your model's label, and ask your clinician and your plan.
How long is the Medicare TENS trial period?
For chronic pain, the Medicare TENS policy says the unit must be used on a trial basis for a minimum of one month (30 days), but not to exceed two months. The trial is paid as a rental, and the treating practitioner must monitor it. For acute post-operative pain, coverage is limited to 30 days from the day of surgery. This is as of the LCD revision effective January 1, 2024.
Can I buy a TENS unit online and get Medicare to pay?
Probably not on your own. Medicare.gov says it will only pay for DME items you get from suppliers who are enrolled in Medicare. The Medicare TENS policy also requires an order from the treating practitioner. Before you buy, ask your doctor and call Medicare or your plan to confirm what they will pay for.
Read moreSource: Medicare.gov, CMS
Will my Medicare Advantage plan cover TENS the same way?
Not necessarily. Medicare.gov says that if you are in a Medicare Advantage Plan, your plan may have different rules. It also says you may need to use doctors in the plan's network and get approval (prior authorization) for certain services. Check with your plan about TENS units, suppliers and approvals before you get one.
Read moreSource: Medicare.gov, Medicare.gov
What if my TENS coverage is denied?
You can usually appeal. Medicare.gov says Original Medicare has 5 levels of appeal, and if you disagree with a decision you can usually go to the next level. It advises you to ask your provider or supplier for information that makes your appeal stronger. If you have a Medicare Advantage plan or other insurance, check your plan's appeal steps.
Read moreSource: Medicare.gov, Medicare.gov
Safety
Is it safe to use a TENS unit every day?
Your clinician decides what is right for you. University of Iowa Health Care says some people use TENS daily, and that it should not harm your body but can cause some skin irritation from the patches. It says to stop and talk with your care team if you have skin irritation, headache, dizziness or nausea. Follow your clinician's and your device's instructions.
Read moreSource: University of Iowa Health Care, University of Iowa Health Care, University of Iowa Health Care
What are the side effects of a TENS unit?
The most common one is skin irritation. University of Iowa Health Care says to stop using TENS and talk with your care team if you have skin irritation, headache, dizziness or nausea. The NHS says if skin becomes itchy, irritated or red, turn off the machine and remove the pads. People allergic to nickel or adhesives may have skin irritation.
Read moreSource: University of Iowa Health Care, NHS, University of Iowa Health Care
Can I use a TENS unit with a pacemaker?
No. The NHS says do not use TENS if you have a pacemaker. University of Iowa Health Care says not to use TENS if you have a cardiac pacemaker or defibrillator, a spinal cord stimulator, or any implanted metallic or electronic device. Talk with your doctor before any TENS use if you have an implant.
Is a TENS unit safe in pregnancy?
Not unless your doctor or midwife says so. The NHS says do not use TENS if you are pregnant, unless your doctor or midwife tells you to. University of Iowa Health Care tells you to talk with your health care provider first if you are pregnant. Always ask your own clinician before you start.
Can you use a TENS unit while sleeping?
No. The NHS says do not use TENS while you sleep. University of Iowa Health Care also lists sleeping among times not to use TENS, and notes that wires can tangle or unplug and the patches may come off. Not wearing it to bed also lets your skin rest. Follow your clinician's and your device's instructions.
Read moreSource: NHS, University of Iowa Health Care, University of Iowa Health Care
Where should you not use a TENS unit?
University of Iowa Health Care lists open wounds or rashes, swollen, red, infected or inflamed skin, cancerous lesions, skin without normal feeling, any part of the head or face, any part of the throat, both sides of the chest or trunk at once, and directly on the backbone. The NHS adds the neck, mouth and eyes. Ask your clinician if you are unsure.
For clinics
What must a physician document to order a TENS unit?
For Medicare, the LCD says the ordering practitioner must be the treating practitioner for the condition. The trial period must be monitored by that practitioner. For a unit ordered with 4 leads, the medical record must document why 2 leads are insufficient. CMS also describes face-to-face encounter rules for listed items. Check the current LCD and your payer's policy.
Can the TENS unit be delivered before the written order arrives?
For items subject to the rule, no. The CMS TENS policy article says that if a supplier delivers an item before it receives a written order prior to delivery, the claim is denied as not reasonable and necessary. CMS says the rule applies to items on its required list. Check whether your TENS code is on the current list.
When is a 4-lead TENS unit justified?
The Medicare LCD says a 4-lead unit may be used with either 2 leads or 4 leads, depending on the characteristics of the beneficiary's pain. If it is ordered for use with 4 leads, the medical record must document why 2 leads are insufficient to meet the beneficiary's needs. This is as of the revision effective January 1, 2024.
About the company
How do I reach Analgesic Healthcare?
Call toll free (800) 749-1188. The Analgesic Healthcare contact page also lists the phone number (813) 915 8367 and the email address contact@analgesichealthcare.com. The Live Chat page says live chat is available through the chat icon at the bottom right corner of the website, where you give your name and email.
Read moreSource: Analgesic Healthcare, Analgesic Healthcare, Analgesic Healthcare
Where is Analgesic Healthcare located?
Analgesic Healthcare, Inc. is based at 7823 N. Dale Mabry Highway, Tampa, Florida 33614. Its contact page lists this address as its Corporate Headquarters. Analgesic Healthcare says it has served patients since 1978. You can reach the company toll free at (800) 749-1188.
How do I pay an invoice?
Use the Pay Invoice link in the header menu of the Analgesic Healthcare website. It opens a window with a button labeled Go to Payment Processing Portal. For questions about an invoice, call toll free (800) 749-1188 or use the live chat on the website.
How does a clinic send a preauthorization to Analgesic Healthcare?
Doctors and physical therapists use the patient preauthorization form for TENS units on the Analgesic Healthcare website. The form asks for the doctor or PT name and the patient's name, date of birth, insurance name and insurance ID number. Fill it out and submit it to Analgesic Healthcare. Questions go to contact@analgesichealthcare.com.
Is Analgesic Healthcare accredited?
Analgesic Healthcare says it has received accreditation from the Accreditation Commission for Health Care (ACHC). This statement is on its contact page. It comes from the company itself, not from a third party. For details about the accreditation, such as the program and dates, call toll free (800) 749-1188.
Read moreSource: Analgesic Healthcare
These answers give general information, not medical advice. Talk with your doctor or physical therapist about your own care. In an emergency, call 911.
Questions about your TENS unit or an invoice?
Call toll free. For customer service, ask for extension 508.
