Archived Policies - Mental Health
TEXAS: There is a LEGISLATIVE MANDATE. Refer to the Legislation section.
ILLINOIS and NEW MEXICO: Neurofeedback is considered investigational for all indications.
Neurofeedback training or therapy, also called neurotherapy, is a term used to describe the feedback of neural information to patients with certain central nervous system (CNS) disorders in an attempt to teach these patients to modify their brain function. Neurofeedback may be conceptualized as a type of biofeedback that uses electroencephalogram (EEG) as a source of feedback data. "Feedback" simply refers to feeding information about the patient's behavior back to them. The theory is that using the EEG as a measure of CNS functioning can help train patients to modify or control their brain wave function by staying focused and concentrating.
Proponents claim that neurofeedback can be used in the treatment of a variety of conditions, including:
For certain patients, neurofeedback is sometimes combined with regular biofeedback. The theory is that relaxed concentration promotes an optimal state for learning.
Upon reviewing the literature, there was inadequate data to permit conclusions regarding the health outcome effects of neurofeedback for any indication. Among the available studies reviewed in the 1997 BCBSA TEC Assessment, few were randomized controlled trials and those that were did not support the efficacy of neurofeedback in improving health outcomes. Of the few randomized clinical trials reported, only two studies used appropriate control conditions.
Information on specific coverage allowance of neurofeedback contained in this policy is mandated by the Texas Legislature for Texas contracts only.
Each benefit plan, summary plan description or contract defines which services are covered, which services are excluded, and which services are subject to dollar caps or other limitations, conditions or exclusions. Members and their providers have the responsibility for consulting the member's benefit plan, summary plan description or contract to determine if there are any exclusions or other benefit limitations applicable to this service or supply. If there is a discrepancy between a Medical Policy and a member's benefit plan, summary plan description or contract, the benefit plan, summary plan description or contract will govern.
When benefits are paid for neurofeedback services, they should be paid as an illness, not as a psychiatric service.
|Title:||Effective Date:||End Date:|
|Biofeedback for Miscellaneous Indications||07-01-2018||02-14-2019|
|Biofeedback for Miscellaneous Indications||07-15-2017||06-30-2018|
|Biofeedback for Miscellaneous Indications||04-01-2016||07-14-2017|
|Biofeedback for Miscellaneous Indications||10-01-2015||03-31-2016|
|Biofeedback for Miscellaneous Indications||12-01-2014||09-30-2015|
|Biofeedback for Miscellaneous Indications||02-01-2013||11-30-2014|
|Biofeedback and Neurofeedback||02-15-2009||01-31-2013|
|Biofeedback and Neurofeedback||06-15-2007||02-14-2009|
|Biofeedback and Neurofeedback||01-01-2006||06-14-2007|