Aetna modified CPB 0029 covering thermography, effective September 26, 2025. CPT 93740 (temperature gradient studies) remains non-covered for all listed indications. Here's what billing teams need to do.
Aetna, a CVS Health company, updated its thermography coverage policy under CPB 0029 on September 26, 2025. The policy governs CPT 93740 — temperature gradient studies — and classifies it as not covered across a wide range of diagnoses. The ICD-10 code list tied to this policy spans 351 codes, covering everything from malignant neoplasms (C00.0–C96.9) to complex regional pain syndrome (G90.50–G90.59) to dry eye syndrome (H04.121–H04.129). If your team still bills thermography against any of these diagnoses, expect a claim denial.
Quick-Reference Table
| Field | Detail |
|---|---|
| Payer | Aetna (CVS Health) |
| Policy | Thermography — CPB 0029 |
| Policy Code | CPB 0029 |
| Change Type | Modified |
| Effective Date | September 26, 2025 |
| Impact Level | Medium — low billing volume procedure, but high denial risk if still in charge master |
| Specialties Affected | Radiology, pain management, neurology, oncology, ophthalmology, vascular surgery, endocrinology |
| Key Action | Audit your charge capture and remove or flag CPT 93740 for all Aetna claims before September 26, 2025 |
Aetna Thermography Coverage Criteria and Medical Necessity Requirements 2025
The Aetna thermography coverage policy under CPB 0029 is straightforward: thermography does not meet medical necessity criteria for any of the listed indications. Aetna does not cover CPT 93740 for temperature gradient studies regardless of the clinical scenario or diagnosis code attached.
This is not a conditional non-coverage policy. There are no prior authorization pathways that unlock reimbursement. There are no exceptions for specific diagnoses, patient populations, or care settings.
The scope is broad. The 351 ICD-10 codes associated with this policy include malignant neoplasms (C00.0–C96.9), diabetes mellitus with circulatory complications (E10.51–E11.59), complex regional pain syndrome (G90.50–G90.59), carpal tunnel syndrome (G56.0–G56.3), coronary atherosclerosis (I25.10–I25.9), peripheral vascular diseases (I73.0–I73.7), and postherpetic trigeminal neuralgia (B02.22). If a provider is using thermography as a diagnostic tool in any of these clinical contexts, Aetna will not pay.
The real issue here is that thermography has been marketed aggressively in certain specialties — particularly breast health and pain management — as an adjunct or alternative to standard imaging. Aetna's position is that the clinical evidence doesn't support coverage. That position hasn't changed with this update.
Prior authorization won't help you here. Aetna's billing guidelines are clear: CPT 93740 is not a covered service under this policy. Submitting a prior auth request for a non-covered service wastes time and delays other workflows.
Aetna Thermography Exclusions and Non-Covered Indications
CPT 93740 carries a single group label in CPB 0029: "CPT codes not covered for indications listed in the CPB." That's Aetna's formal designation for procedures it considers unproven, investigational, or lacking sufficient clinical evidence for routine coverage.
This is the same designation Aetna uses across policies for procedures where peer-reviewed evidence doesn't support clinical utility. It's a strong signal that this isn't a coverage limitation waiting to be appealed — it's a fundamental medical necessity determination.
The non-covered indications span multiple clinical domains. Oncology practices billing thermography for malignant neoplasm workup (C00.0–C96.9), pain clinics using it for complex regional pain syndrome (G90.50–G90.59), and ophthalmology practices using it for dry eye syndrome (H04.121–H04.129) are all equally affected. The breadth of the ICD-10 code list in CPB 0029 is the tell — Aetna isn't carving out a narrow niche of non-coverage. It's saying thermography doesn't meet medical necessity standards, period.
Coverage Indications at a Glance
| Indication | Status | Relevant Codes | Notes |
|---|---|---|---|
| Malignant neoplasms | Not Covered | C00.0–C96.9; CPT 93740 | No prior auth pathway available |
| Complex regional pain syndrome | Not Covered | G90.50–G90.59; CPT 93740 | Includes all laterality variants |
| Carpal tunnel syndrome | Not Covered | G56.0–G56.3; CPT 93740 | All laterality variants |
| Diabetes mellitus with circulatory complications | Not Covered | E10.51–E11.59; CPT 93740 | Type 1 and Type 2 included |
| Coronary atherosclerosis | Not Covered | I25.10–I25.9; CPT 93740 | Full range of coronary artery disease codes |
| Peripheral vascular diseases | Not Covered | I73.0–I73.7; CPT 93740 | Includes Raynaud's and related conditions |
| Postherpetic neuralgia (trigeminal) | Not Covered | B02.22, B02.29; CPT 93740 | Both trigeminal and other nervous system involvement |
| Dry eye syndrome | Not Covered | H04.121–H04.129; CPT 93740 | All laterality variants |
| Corneal disorder due to contact lens | Not Covered | H18.821–H18.829; CPT 93740 | All laterality variants |
| Ocular pain | Not Covered | H57.10–H57.12; CPT 93740 | Includes unspecified and bilateral |
| Leprosy (Hansen's disease) | Not Covered | A30.0–A30.9; CPT 93740 | Full range of classification types |
| Hemangioma and lymphangioma | Not Covered | D18.0–D18.9; CPT 93740 | Any site |
| Localized adiposity | Not Covered | E65; CPT 93740 | Brown adipose tissue activation context |
| Muscular dystrophy | Not Covered | G71.09; CPT 93740 | Other specified muscular dystrophies |
| Cerebral vasospasm and vasoconstriction | Not Covered | I67.841–I67.848; CPT 93740 | All specified variants |
Aetna Thermography Billing Guidelines and Action Items 2025
The effective date is September 26, 2025. That's your deadline. Here's what to do before then.
| # | Action Item |
|---|---|
| 1 | Audit your charge master for CPT 93740. Pull every active charge description that includes temperature gradient studies. Flag it for Aetna claims specifically. If your system allows payer-specific charge routing, set CPT 93740 to route to a denial-prevention hold for Aetna. |
| 2 | Review your open claims queue. Any CPT 93740 claim submitted to Aetna with an effective date on or after September 26, 2025 is at high risk for claim denial. Pull those claims now and assess whether you can recode to a covered, medically appropriate alternative — or whether the service simply can't be billed. |
| 3 | Educate your ordering providers. Pain management, oncology, ophthalmology, and vascular surgery practices are the most exposed here. Brief your medical director on the scope of ICD-10 codes in CPB 0029. If providers are ordering thermography as a diagnostic adjunct, they need to know Aetna won't pay — and that ordering it puts patients at risk of surprise bills. |
| 4 | Check your ABN workflow. If you're in a specialty that routinely uses thermography, you need a valid Advance Beneficiary Notice process for Aetna patients. This isn't a Medicare-specific tool — the concept applies to commercial payers too. Patients should know before the service that it won't be covered. Build that notification step into your scheduling workflow. |
| 5 | Don't appeal on medical necessity grounds. Aetna's coverage policy here is explicit. Medical necessity appeals for CPT 93740 against the listed ICD-10 codes will fail. The only viable appeal scenario is a documentation error — wrong code, wrong patient, wrong payer. Anything else is wasted effort. |
| 6 | Loop in your compliance officer if your practice has meaningful thermography volume. If CPT 93740 represents more than a handful of annual claims, your compliance officer should review whether past billing patterns need a retroactive audit. Talk to your billing consultant before September 26, 2025. |
| Previous Version | Current Version |
|---|---|
| Coverage is considered experimental and investigational for all indications | Coverage is considered medically necessary when specific criteria are met |
| Prior authorization is not required | Prior authorization is required for initial treatment |
| Documentation must include clinical history | Documentation must include clinical history |
| Re-review every 24 months | Re-review every 12 months with updated clinical documentation |
CPT, HCPCS, and ICD-10 Codes for Thermography Under CPB 0029
Not Covered CPT Codes
| Code | Type | Description | Status |
|---|---|---|---|
| 93740 | CPT | Temperature gradient studies | Not covered for indications listed in CPB 0029 |
Key ICD-10-CM Diagnosis Codes
The following codes represent the range of diagnoses addressed in CPB 0029. All are associated with non-coverage of CPT 93740.
| Code(s) | Description |
|---|---|
| A30.0–A30.9 | Leprosy (Hansen's disease) — all classification types |
| B02.22 | Postherpetic trigeminal neuralgia |
| B02.29 | Other postherpetic nervous system involvement |
| C00.0–C96.9 | Malignant neoplasms (full range) |
| D18.0–D18.9 | Hemangioma and lymphangioma, any site |
| E08.3211–E13.37x9 | Diabetes mellitus (full range) |
| E10.51–E10.59 | Type 1 diabetes mellitus with circulatory complications |
| E11.51–E11.59 | Type 2 diabetes mellitus with circulatory complications |
| E65 | Localized adiposity (brown adipose tissue activation) |
| G56.0–G56.3 | Carpal tunnel syndrome (all laterality variants) |
| G71.09 | Other specified muscular dystrophies |
| G90.50–G90.59 | Complex regional pain syndrome (all variants) |
| H04.121–H04.129 | Dry eye syndrome (all laterality variants) |
| H18.821–H18.829 | Corneal disorder due to contact lens (all laterality variants) |
| H57.10–H57.12 | Ocular pain |
| I25.10–I25.9 | Coronary atherosclerosis |
| I67.841–I67.848 | Cerebral vasospasm and vasoconstriction |
| I73.0–I73.7 | Other peripheral vascular diseases |
Note: CPB 0029 includes 351 total ICD-10-CM codes. The table above covers the code ranges and representative codes from the policy data. Review the full policy at app.payerpolicy.org/p/aetna/0029 for the complete list before the effective date of September 26, 2025.
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