Archived Policies - Mental Health
FOR TEXAS (when not used to treat an acquired brain injury), ILLINOIS and NEW MEXICO:
Biofeedback therapy, utilizing electromyographic or skin temperature measurements, is considered medically necessary used for the treatment of the following diagnosed conditions:
Biofeedback therapy is considered investigational for:
Special Comment on Management of Biofeedback Therapy:
Biofeedback therapy should be:
Biofeedback is training procedures aimed at helping a patient achieve control over a physiologic process/function. Biofeedback therapy provides the patient with visual, auditory, or other signals from a monitoring device allowing the patient to voluntarily exert control over the targeted body function. The functions are transformed into a tone or light, the loudness or brightness of which shows the extent of activity. The functions monitored are:
Biofeedback therapy differs from electromyography; a diagnostic procedure used to record and studies the electrical properties of skeletal muscles. An electromyography device may be used to provide biofeedback information to the patient.
There have been numerous controlled studies demonstrating some degree of clinical effectiveness of biofeedback in a wide spectrum of clinical problems.
There are several methodologic difficulties in assessing biofeedback. For example, most interventions that include biofeedback are multimodal and include relaxation and behavioral instruction (which may have an independent effect). While studies may report a beneficial effect of multimodality treatment, without appropriate control conditions, it is impossible to isolate the specific contribution of biofeedback to the overall treatment effect. For example, relaxation, attention, or suggestion may account for the successful results that have been attributed to biofeedback.
Information on specific coverage allowance of biofeedback 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 biofeedback services for the diagnosis of an acquired brain injury, 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|