Medical necessity

Medicare.gov describes medically necessary services as services or supplies that meet accepted standards of medical practice to diagnose or treat your medical condition. Medicare's TENS policy uses the words reasonable and necessary. The policy says a TENS unit is denied as not reasonable and necessary for chronic low back pain, and it lists headache among conditions not considered reasonable and necessary. Your clinician's notes in your record show why a unit is needed. Other payers can use different definitions, so check with your plan. See Does Medicare cover a TENS unit? for the rule as of the LCD revision effective January 1, 2024.