Aetna modified CPB 0710 covering actigraphy and accelerometry, effective October 16, 2025. CPT 95803 and Category III codes 0533T–0536T are not covered for any of the 26+ listed indications. Here's what billing teams need to know.
Aetna, a CVS Health company, updated its actigraphy and accelerometry coverage policy under CPB 0710 in the Aetna system. The policy now carries an expanded, explicit list of non-covered indications spanning sleep disorders, psychiatric conditions, movement disorders, and epilepsy monitoring. If your practice bills CPT 95803 for actigraphy or 0533T–0536T for continuous movement disorder recording, this update affects your charge capture and denial risk starting October 16, 2025.
Quick-Reference Table
| Field | Detail |
|---|---|
| Payer | Aetna, a CVS Health company |
| Policy | Actigraphy and Accelerometry |
| Policy Code | CPB 0710 |
| Change Type | Modified |
| Effective Date | October 16, 2025 |
| Impact Level | High — broad non-coverage across multiple specialties |
| Specialties Affected | Sleep medicine, neurology, psychiatry, pulmonology, geriatrics, rehabilitation medicine, pain management |
| Key Action | Audit all claims for CPT 95803 and 0533T–0536T before October 16, 2025, and remove these codes from charge capture pathways for the listed diagnoses |
Aetna Actigraphy and Accelerometry Coverage Criteria and Medical Necessity Requirements 2025
The real issue here: Aetna's CPB 0710 Aetna system update contains no covered indications for actigraphy or accelerometry. The entire policy is a non-coverage bulletin. There is no pathway to reimbursement for CPT 95803 or 0533T–0536T under any of the listed diagnoses.
Aetna's position is that the clinical evidence does not establish the effectiveness of actigraphy or accelerometry for any of the indications in the policy. That's a broad statement, and it covers a wide range of diagnostic and monitoring uses that some providers bill routinely.
The actigraphy and accelerometry billing landscape shifted for Aetna members before this update, but the October 16, 2025 effective date makes the expanded indication list official and enforceable. If you've been submitting CPT 95803 for sleep disorder workups or 0533T–0536T for Parkinson's monitoring and receiving inconsistent denials, this update tells you why — and confirms those denials aren't going away.
No prior authorization will save these claims. The policy designates all listed indications as experimental, investigational, or unproven. Prior authorization for services Aetna considers experimental is irrelevant — authorization doesn't guarantee medical necessity, and Aetna can still deny on clinical grounds post-service.
Aetna Actigraphy and Accelerometry Exclusions and Non-Covered Indications
This section is the heart of CPB 0710, and it's extensive. Aetna considers actigraphy testing — including devices like the Actiwatch, AW-64, and Emfit — experimental and unproven for 17 specific indications. The list is labeled "not all-inclusive," which means Aetna can deny actigraphy claims for unlisted diagnoses too.
Actigraphy Non-Covered Indications
The 17 indications Aetna lists for CPT 95803 non-coverage are:
| # | Excluded Procedure |
|---|---|
| 1 | Defining lithium response dimensions in bipolar disorders (F31.10–F31.9) |
| 2 | Detection or screening of apnea |
| 3 | Detection of seizures during sleep |
| 4 | Diagnosis of Alzheimer's disease (G30.0–G30.9) |
| 5 | Diagnosis of hypertension (I10–I16.9) |
| 6 | Diagnosis of sleep disorders — including central disorders of hypersomnolence, insomnia, periodic limb movements of sleep, sleep-disordered breathing, and sleep-wake disturbance (G47.0–G47.9) |
| 7 | Evaluation of depression (F32.0–F33.9) |
| 8 | Evaluation of disruptive mood dysregulation disorder (F34.81) |
| 9 | Evaluation of motor fluctuations in persons with Parkinson's disease (G20.A1–G20.C) |
| 10 | Evaluation of post-traumatic stress disorder (F43.10–F43.12) |
| 11 | Evaluation of schizophrenia (F20.0–F23) |
| 12 | Improving walking ability and quality of life in individuals with intermittent claudication |
| 13 | Actigraphy in the setting of opioid detoxification (F11.20–F11.29) |
| 14 | Monitoring daily life physical activity in pulmonary arterial hypertension (I27.21) |
| 15 | Monitoring individuals with motor neuron diseases (G12.20–G12.29) |
| 16 | Monitoring treatment response for sleep and circadian rhythm dysfunction associated with depression |
| 17 | Screening for idiopathic REM sleep behavior disorder |
That last one — REM sleep behavior disorder screening — is worth flagging. Sleep medicine practices often use actigraphy as part of an early workup before polysomnography. Aetna is explicitly excluding this use.
Accelerometry Non-Covered Indications
Accelerometry devices — including the Kinesia and Tremerometer — are non-covered under codes 0533T–0536T for nine indications:
| # | Excluded Procedure |
|---|---|
| 1 | Evaluating functional ability in the elderly |
| 2 | Differential diagnosis of tremor syndromes (G25.0–G25.2) |
| 3 | Evaluating sleep disturbances in Parkinson's disease (G20.A1–G20.C, G21.0–G21.9) |
| 4 | Gait analysis in persons with hip osteoarthritis |
| 5 | Improving walking ability and quality of life in intermittent claudication |
| 6 | Measuring disease activity in children with eczema |
| 7 | Monitoring physical activity during rehabilitation after stroke (I63.0–I63.9) |
| 8 | Monitoring physical activity in critically ill persons |
| 9 | Monitoring physical motion and muscle activity to quantify kinematics of movement disorder symptoms including tremor |
The Parkinson's disease indications appear twice — once under actigraphy for motor fluctuations, once under accelerometry for sleep disturbances and movement disorder kinematics. If your neurology team is using either device type for Parkinson's monitoring, both CPT families are denied.
Epilepsy Monitoring Systems
Aetna also calls out epilepsy monitoring systems that combine accelerometry and heart rate monitoring. These are non-covered for diagnosing nocturnal epilepsy and for all other indications. The ICD-10 codes G40.001–G40.919 (epilepsy and recurrent seizures) are tied to this exclusion. This is a separate category from the accelerometry and actigraphy buckets above — Aetna is addressing combined-modality monitoring devices specifically.
Coverage Indications at a Glance
| Indication | Status | Relevant CPT Codes | Key ICD-10 Codes | Notes |
|---|---|---|---|---|
| Sleep disorder diagnosis (insomnia, hypersomnia, PLMS, SDB) | Not Covered — Experimental | 95803 | G47.0–G47.9 | Applies to all sleep disorder subtypes listed |
| Bipolar disorder — lithium response | Not Covered — Experimental | 95803 | F31.10–F31.9 | |
| Alzheimer's disease diagnosis | Not Covered — Experimental | 95803 | G30.0–G30.9 | |
| Hypertension diagnosis | Not Covered — Experimental | 95803 | I10–I16.9 | |
| Depression evaluation | Not Covered — Experimental | 95803 | F32.0–F33.9 | Includes circadian rhythm monitoring for depression |
| Disruptive mood dysregulation disorder | Not Covered — Experimental | 95803 | F34.81 | |
| PTSD evaluation | Not Covered — Experimental | 95803 | F43.10–F43.12 | |
| Schizophrenia evaluation | Not Covered — Experimental | 95803 | F20.0–F23 | |
| Parkinson's — motor fluctuations | Not Covered — Experimental | 95803 | G20.A1–G20.C | |
| Opioid detoxification monitoring | Not Covered — Experimental | 95803 | F11.20–F11.29 | |
| Pulmonary arterial hypertension activity monitoring | Not Covered — Experimental | 95803 | I27.21 | |
| Motor neuron disease monitoring | Not Covered — Experimental | 95803 | G12.20–G12.29 | |
| REM sleep behavior disorder screening | Not Covered — Experimental | 95803 | G47.0–G47.9 | |
| Apnea detection/screening | Not Covered — Experimental | 95803 | — | See CPB 0004 for sleep apnea coverage |
| Seizure detection during sleep | Not Covered — Experimental | 95803 | — | |
| Tremor syndrome differential diagnosis | Not Covered — Experimental | 0533T–0536T | G25.0–G25.2 | |
| Parkinson's — sleep disturbances | Not Covered — Experimental | 0533T–0536T | G20.A1–G20.C, G21.0–G21.9 | |
| Parkinson's — movement disorder kinematics | Not Covered — Experimental | 0533T–0536T | G20.A1–G20.C | |
| Stroke rehabilitation activity monitoring | Not Covered — Experimental | 0533T–0536T | I63.0–I63.9 | |
| Elderly functional ability evaluation | Not Covered — Experimental | 0533T–0536T | — | |
| Gait analysis — hip osteoarthritis | Not Covered — Experimental | 0533T–0536T | — | |
| Eczema disease activity in children | Not Covered — Experimental | 0533T–0536T | — | |
| Critically ill — physical activity monitoring | Not Covered — Experimental | 0533T–0536T | — | |
| Epilepsy monitoring (accelerometry + HR) — nocturnal epilepsy | Not Covered — Experimental | 0533T–0536T | G40.001–G40.919 | Applies to all epilepsy indications |
| Intermittent claudication — walking/QOL (actigraphy) | Not Covered — Experimental | 95803 | — | |
| Intermittent claudication — walking/QOL (accelerometry) | Not Covered — Experimental | 0533T–0536T | — |
Aetna Actigraphy and Accelerometry Billing Guidelines and Action Items 2025
| # | Action Item |
|---|---|
| 1 | Remove CPT 95803 from charge capture for all diagnoses in the non-covered list before October 16, 2025. The updated policy is explicit. Submitting 95803 with G47.x, F32.x, F31.x, G20.x, or any other listed ICD-10 code will trigger a claim denial. Update your charge capture rules now — don't wait for remittances to tell you. |
| 2 | Pull and review all CPT 0533T–0536T claims submitted in the last 90 days. Check whether any were billed with G25.0–G25.2 (tremor), G20.A1–G20.C (Parkinson's), I63.x (stroke), or G40.001–G40.919 (epilepsy). These are the highest-exposure ICD-10 families for accelerometry denials under the updated coverage policy. |
| 3 | Notify your neurology and sleep medicine providers before the October 16, 2025 effective date. These specialties carry the highest volume of actigraphy and accelerometry billing. Providers ordering the Actiwatch, AW-64, Emfit, Kinesia, or Tremerometer for any Aetna patient need to know this isn't a reimbursement pathway — it's a denial waiting to happen. |
| 4 | Do not rely on prior authorization as a workaround. Aetna's experimental designation means prior authorization is irrelevant. A service Aetna deems unproven can be denied even with an approved auth. If a provider is pushing for actigraphy with prior auth, your billing team should flag it before the claim goes out. |
| 5 | Check CPB 0004 and CPB 0330 for sleep-related coverage alternatives. Aetna links CPB 0004 (Obstructive Sleep Apnea in Adults) and CPB 0330 (Multiple Sleep Latency Test) as related policies. If a sleep workup genuinely requires objective testing, polysomnography or MSLT may carry a covered pathway that actigraphy does not. Redirect orders there where clinically appropriate. |
| 6 | Document medical necessity carefully for any adjacent services. If a patient needs both a covered diagnostic study and some form of activity monitoring, make sure the covered service is coded and documented correctly. Mixing in a non-covered actigraphy or accelerometry code on the same claim can draw attention to the entire encounter. |
| 7 | If your practice uses a combined epilepsy monitoring system with accelerometry and heart rate monitoring, stop billing those services to Aetna. The policy is categorical — these devices are non-covered for nocturnal epilepsy diagnosis and for all other indications. There's no qualifying criteria to meet. |
| 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 Actigraphy and Accelerometry Under CPB 0710
Not Covered / Experimental CPT Codes
| Code | Type | Description | Coverage Status |
|---|---|---|---|
| 95803 | CPT | Actigraphy testing, recording, analysis, interpretation and report (minimum of 72 hours to 14 consecutive days) | Not covered for indications listed in CPB 0710 |
| 0533T | CPT (Category III) | Continuous recording of movement disorder symptoms, including accelerometry and/or gyroscopy | Not covered for indications listed in CPB 0710 |
| 0534T | CPT (Category III) | Continuous recording of movement disorder symptoms, including accelerometry and/or gyroscopy — each additional 30 days | Not covered for indications listed in CPB 0710 |
| 0535T | CPT (Category III) | Continuous recording of movement disorder symptoms — physician or other qualified health care professional review, analysis and report | Not covered for indications listed in CPB 0710 |
| 0536T | CPT (Category III) | Continuous recording of movement disorder symptoms — remote physiologic monitoring treatment management services | Not covered for indications listed in CPB 0710 |
Key ICD-10-CM Diagnosis Codes
The following diagnosis codes appear in the CPB 0710 non-coverage list. These are the ICD-10 codes most likely to appear on denied claims.
| Code Range | Description |
|---|---|
| F11.20–F11.29 | Opioid dependence (various specifiers) |
| F20.0–F23 | Schizophrenia, schizotypal disorder, delusional disorders, brief psychotic disorder |
| F31.10–F31.9 | Bipolar disorder (various specifiers) |
| F32.0–F33.9 | Major depressive disorder, single and recurrent |
| F34.81 | Disruptive mood dysregulation disorder |
| F43.10–F43.12 | Post-traumatic stress disorder (unspecified, acute, chronic) |
| G12.20–G12.29 | Motor neuron disease (various subtypes) |
| G20.A1–G20.C | Parkinson's disease (various stages) |
| G21.0–G21.9 | Secondary parkinsonism (various causes) |
| G25.0–G25.2 | Essential and other specified forms of tremor |
| G30.0–G30.9 | Alzheimer's disease (various specifiers) |
| G40.001–G40.919 | Epilepsy and recurrent seizures |
| G47.0–G47.9 | Sleep disorders (various subtypes) |
| I10–I16.9 | Hypertensive diseases |
| I27.21 | Secondary pulmonary arterial hypertension |
| I63.0–I63.9 | Cerebral infarction (stroke) |
The ICD-10 list in the full CPB 0710 policy contains 262 diagnosis codes. The ranges above cover the primary clinical categories. If you work in a specialty with high volumes of any of these diagnoses — neurology, sleep medicine, psychiatry, pulmonology — run a claims audit against these ranges before October 16, 2025.
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