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TENS Supplies Unit Limit

Thursday, March 18, 2021

The Defense Health Agency and Health Net Federal Services, LLC (HNFS) have noticed an increase in claims for Healthcare Common Procedure Coding System (HCPCS) A4595 – electrical stimulator supplies (e.g., TENS) – with unit counts that far exceed the HCPCS manual description of one unit/two leads per month. As a result, and to allow for two- and four-lead TENS, we have updated our claims processing systems to impose a limit of two units/four leads per month for TENS supplies billed under A4595. This change went into effect on Feb. 17, 2021. 

Currently, TRICARE policy does not specify a unit limit for A4595; however, contractors such as HNFS are given discretion to set limits where none exist, based on best business practices. For dates of service Feb. 17, 2021 and after, units in excess of two units/four leads per month for A4595 will not be reimbursed. Please make note of this when prescribing and billing for TENS supplies.

We appreciate your cooperation with this guideline.

Find additional benefit details on our Transcutaneous Electrical Nerve Stimulation (TENS) benefits page.