TL;DR: Aetna, a CVS Health company, modified CPB 0676 — its electrical stimulation coverage policy for nausea, vomiting, and motion sickness — effective October 8, 2025. Here's what billing teams need to know before claims start hitting the wall.

This update to CPB 0676 Aetna tightens the line between covered and non-covered uses of transcutaneous electrical acupoint stimulation (TEAS) devices like PrimaBella and ReliefBand. The policy now names over 25 specific indications as experimental or investigational — a long list that will catch billing teams off guard if they haven't updated their charge capture. Primary codes affected include CPT 0783T for transcutaneous auricular neurostimulation setup, CPT 97813 for acupuncture with electrical stimulation (initial 15 minutes), and add-on CPT 97814 for each additional 15 minutes.


Quick-Reference Table

Field Detail
Payer Aetna
Policy Electrical Stimulation for Nausea, Vomiting and Motion Sickness (PrimaBella and ReliefBand) and Other Selected Indications
Policy Code CPB 0676
Change Type Modified
Effective Date October 8, 2025
Impact Level Medium — narrow covered criteria, broad experimental exclusions
Specialties Affected Oncology, OB/GYN, anesthesiology, surgery, neurology, pain management
Key Action Audit all TEAS claims billed to Aetna and confirm the indication meets medical necessity criteria before October 8, 2025

Aetna Electrical Stimulation Coverage Criteria and Medical Necessity Requirements 2025

The Aetna electrical stimulation coverage policy under CPB 0676 covers two device types — ReliefBand and PrimaBella — but only in specific prescription versions and only for specific diagnoses. The over-the-counter version of ReliefBand doesn't qualify. Full stop.

Here's exactly what meets medical necessity under this policy:

ReliefBand (prescription version only):

#Covered Indication
1Post-operative nausea — but only when antiemetics and other conservative therapies have already failed
2Chemotherapy-induced nausea — same requirement: the patient must have tried and failed antiemetics first

PrimaBella or ReliefBand (prescription version only):

#Covered Indication
1Hyperemesis gravidarum — only when conservative therapy has failed (diet changes, ginger capsules, vitamin B6)

That's the entire covered universe for this policy. Three indications. Both require documented failure of prior treatments — which means your clinical documentation needs to show the treatment progression before Aetna will consider reimbursement.

When billing CPT 97813 (initial 15-minute acupuncture with electrical stimulation) or CPT 97814 (each additional 15 minutes), the diagnosis code must map cleanly to one of those three covered indications. If the ICD-10 on the claim points to anything outside that list, expect a claim denial.

Prior authorization requirements aren't explicitly called out in the current CPB 0676 text, but given the "unresponsive to prior therapy" language, Aetna reviewers will look for step therapy documentation in medical records. Treat this like it requires prior authorization in practice — document the conservative therapy failure before ordering the device.


Aetna Electrical Stimulation Exclusions and Non-Covered Indications

This is where the policy gets long. Aetna lists more than 25 specific uses of TEAS, transcutaneous auricular neurostimulation, and related technologies as experimental, investigational, or unproven. The coverage policy is explicit: these won't pay.

The pattern here mirrors how Aetna handles other neuromodulation policies — a tight, evidence-based covered set surrounded by a broad experimental exclusion list. If you bill for any of these, you're looking at a claim denial.

The experimental designation applies to:

#Excluded Procedure
1Combined magnetic ball compression with TEAS for post-operative nausea in gynecological laparoscopic surgery
2CPT 0783T (Sparrow Ascent transcutaneous auricular neurostimulation) for opioid withdrawal relief
3TEAS for cerebral palsy motor function improvement in children
+ 28 more exclusions

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

That last point matters: motion sickness is specifically excluded across multiple device categories and modalities. Billing for motion sickness under any formulation — OTC or prescription, TEAS or auricular — will not get paid under this coverage policy.


Coverage Indications at a Glance

Indication Status Relevant Codes Notes
Post-operative nausea (prescription ReliefBand) Covered CPT 97813, 97814 Must fail antiemetics and conservative therapy first
Chemotherapy-induced nausea (prescription ReliefBand) Covered CPT 97813, 97814 Must fail antiemetics and conservative therapy first
Hyperemesis gravidarum (prescription PrimaBella or ReliefBand) Covered CPT 97813, 97814 Must fail diet change, ginger, vitamin B6 first
+ 18 more indications

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

This policy is now in effect (since 2025-10-08). Verify your claims match the updated criteria above.

Aetna Electrical Stimulation Billing Guidelines and Action Items 2025

The effective date is October 8, 2025. That gives your billing team time to fix things before denied claims pile up. Here's what to do.

#Action Item
1

Audit your active TEAS claims for Aetna members now. Pull any claims billed with CPT 97813 or 97814 linked to Aetna. Check every ICD-10 on those claims. If the diagnosis isn't post-op nausea, chemo-induced nausea, or hyperemesis gravidarum — you have a problem to fix before October 8, 2025.

2

Remove OTC ReliefBand from your charge capture entirely for Aetna patients. Aetna does not consider the over-the-counter disposable ReliefBand to be durable medical equipment. Claims for it will not pay. This isn't a prior authorization issue — it's a flat exclusion.

3

Build documentation requirements into your order workflow for covered indications. For post-op nausea and chemo-induced nausea, the chart must show prior antiemetic failure. For hyperemesis gravidarum, document that diet modification, ginger capsules, and vitamin B6 were tried first. Without that documentation, medical necessity reviews will go against you.

+ 3 more action items

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

Sample Version Diff Line-by-line changes
Previous VersionCurrent Version
Coverage is considered experimental and investigational for all indicationsCoverage is considered medically necessary when specific criteria are met
Prior authorization is not requiredPrior authorization is required for initial treatment
Documentation must include clinical historyDocumentation must include clinical history
+ 1 more action items

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

CPT, HCPCS, and ICD-10 Codes for Electrical Stimulation Under CPB 0676

Covered CPT Codes (When Medical Necessity Criteria Are Met)

Code Type Description
97813 CPT Acupuncture with electrical stimulation, initial 15 minutes of personal one-on-one contact
+97814 CPT Acupuncture with electrical stimulation, each additional 15 minutes of personal one-on-one contact

Not Covered / Experimental CPT Codes

Code Type Description Reason
0783T CPT Transcutaneous auricular neurostimulation, set-up, calibration, and patient education Experimental — Sparrow Ascent for opioid withdrawal; combined magnetic ball + TEAS indications
97813 CPT Acupuncture with electrical stimulation, initial 15 minutes Experimental when billed for non-covered indications (see exclusion list above)
+97814 CPT Acupuncture with electrical stimulation, each additional 15 minutes Experimental when billed for non-covered indications
+ 4 more codes

Enter your email to unlock all tables — 100% free

Unlocks every table on this page. Free weekly digest included. By subscribing you agree to our Terms and Privacy Policy.

Note: The VATS CPT code range in the policy data spans CPT 32601 through 32674. All thoracoscopy codes in that range are referenced in the experimental/non-covered group for TEAS analgesia and sleep quality indications.

HCPCS Codes

The policy data for CPB 0676 does not list specific covered HCPCS codes. The OTC ReliefBand device is explicitly excluded from DME coverage — no HCPCS code will generate reimbursement for it under this policy.

Key ICD-10-CM Diagnosis Codes

The policy references 252 ICD-10-CM codes in its full code set. The specific codes in the provided data excerpt are not individually listed, but the clinical indications that map to covered diagnoses include:

Work with your coding team to confirm ICD-10 codes from the full CPB 0676 code list at app.payerpolicy.org/p/aetna/0676. Using an unsupported ICD-10 is the fastest path to a claim denial under this policy.


Get the Full Picture for CPT 97813

Track this policy across versions, search 1,500+ policies by CPT code, and get real-time alerts when any payer changes coverage.

🔍 Search by any code 🔔 Real-time alerts 📊 Line-by-line diffs ⏰ Deadline tracking
Get Full Access → $99/mo · 14-day money-back guarantee