TL;DR: Aetna, a CVS Health company, modified CPB 0827 covering electric tumor treatment fields (ETTF), effective February 19, 2026. Billing teams need to confirm nine medical necessity criteria are documented before billing E0766 and CPT 1025T — and re-authorization every 90 days is not optional.

This Aetna electric tumor treatment fields coverage policy is one of the tighter specialty device policies on the books. CPB 0827 Aetna governs reimbursement for ETTF therapy — marketed as Optune — used in newly diagnosed glioblastoma multiforme (GBM). The primary billing codes are HCPCS E0766 (the device itself), A4555 (replacement electrodes), and CPT 1025T (dosimetry and delivery-simulation modeling). If your team bills any of these, read this carefully before your next claim goes out.


Quick-Reference Table

Field Detail
Payer Aetna
Policy Electric Tumor Treatment Fields — CPB 0827
Policy Code CPB 0827
Change Type Modified
Effective Date February 19, 2026
Impact Level High
Specialties Affected Neuro-oncology, neurosurgery, radiation oncology, durable medical equipment suppliers
Key Action Audit active ETTF cases for all nine medical necessity criteria and verify 90-day re-authorization schedules before billing E0766

Aetna Electric Tumor Treatment Fields Coverage Criteria and Medical Necessity Requirements 2026

Aetna's coverage policy for ETTF is narrow by design. Exactly one diagnosis qualifies: histologically confirmed WHO grade IV astrocytoma — newly diagnosed, supratentorial glioblastoma. Not recurrent GBM. Not other high-grade gliomas. Newly diagnosed, supratentorial, WHO grade IV. That distinction alone drives a large share of claim denials on this code set.

To meet medical necessity under CPB 0827, a member must satisfy all nine of the following criteria simultaneously:

#Covered Indication
1Diagnosis: Histologically confirmed WHO grade IV astrocytoma (newly diagnosed, supratentorial glioblastoma)
2Prior treatment: Maximal debulking surgery (when feasible), followed by concomitant chemotherapy and radiotherapy
3Therapy timing: ETTF initiated within seven weeks of the last dose of concomitant chemotherapy or radiotherapy — whichever is later
+ 6 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.

Every one of these must be documented before you bill E0766. Missing a single criterion — say, a KPS that isn't recorded in the chart, or a start date that falls outside the seven-week window — will result in a claim denial. Build a checklist into your prior authorization workflow now.

The prior authorization requirement doesn't end at initial approval. Continued coverage of ETTF beyond the first three months requires a clinical re-evaluation by the treating practitioner. This must happen no sooner than day 60 and no later than day 91 after therapy starts. Re-authorization is then required every three months after that, based on the same parameters.

That 60-to-91-day window is tight. If your team misses it, you're billing without authorization — and that's a real exposure on durable medical equipment claims. Calendar every re-auth date the day you submit the initial claim.


Aetna Electric Tumor Treatment Fields Exclusions and Non-Covered Indications

Aetna classifies ETTF as experimental, investigational, or unproven for everything outside of newly diagnosed supratentorial GBM. The list of non-covered tumor types is explicit and worth reviewing if your oncology team is running clinical trials or exploring off-label use.

Non-covered indications include ETTF devices used to treat:

#Excluded Procedure
1Breast cancer
2Lung cancer and non-small cell lung cancer (NSCLC)
3Melanoma
+ 6 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.

Aetna also classifies as experimental any combined ETTF therapy paired with chemotherapy or immunotherapy agents other than temozolomide. The specific agents listed as non-covered include bevacizumab, cisplatin, paclitaxel, pemetrexed, lomustine, doxorubicin, cyclophosphamide, dacarbazine, capecitabine, 6-thioguanine, celecoxib, and zinc oxide nanoparticles — across cancer types including breast, colorectal, and hepatocellular carcinoma.

This matters for billing because ICD-10 codes for these diagnoses appear in CPB 0827's code list — but they're there to define what Aetna won't cover. If you're submitting E0766 with a pancreatic cancer diagnosis, expect a denial. The coverage policy does not support it.


Coverage Indications at a Glance

Indication Status Relevant Codes Notes
Newly diagnosed supratentorial GBM (WHO grade IV astrocytoma) Covered E0766, A4555, 1025T, J8700, J9328 All nine criteria must be met; prior authorization required
GBM — continued therapy beyond 90 days Covered with re-auth E0766 Re-evaluation required between day 60–91; re-auth every 3 months
Recurrent or progressive GBM Not Covered Must show no progression by RANO criteria
+ 2 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 2026-02-19). Verify your claims match the updated criteria above.

Aetna Electric Tumor Treatment Fields Billing Guidelines and Action Items 2026

The real issue with electric tumor treatment fields billing is the combination of strict upfront criteria and a rolling re-authorization cycle. Both create denial risk if your team doesn't have a structured workflow.

#Action Item
1

Build a nine-point checklist into your prior auth intake form. Every field that maps to the nine criteria — diagnosis confirmation, KPS score, RANO status, therapy start date relative to last chemo or radiation dose, age, pregnancy status, intracranial device status — must be collected before submitting authorization for E0766. Don't let an incomplete chart slip through.

2

Lock in the therapy start date on day one. The seven-week timing rule is strict. Count back from the last dose of concomitant chemo or radiation, add 49 days, and that's your hard cutoff. Document the start date in the authorization request. If you're close to the edge, flag it immediately.

3

Calendar every re-authorization at the time of initial auth approval. Set your first re-auth reminder for day 55 — five days before the earliest allowed re-evaluation date. The treating physician must conduct an in-person clinical re-evaluation between day 60 and day 91. Missing this window means billing without authorization.

+ 4 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 Electric Tumor Treatment Fields Under CPB 0827

Covered CPT Codes (When Selection Criteria Are Met)

Code Type Description
1025T CPT Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific treatment parameters

Covered HCPCS Codes (When Selection Criteria Are Met)

Code Type Description
E0766 HCPCS Electrical stimulation device used for cancer treatment, includes all accessories, any type
A4555 HCPCS Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
J8700 HCPCS Temozolomide, oral, 5 mg
+ 1 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.

Key ICD-10-CM Diagnosis Codes

The full CPB 0827 code list includes 163 ICD-10-CM codes. The majority define non-covered indications — tumor types Aetna considers experimental for ETTF. The table below includes a representative sample from the policy data. Your billing team should reference the full policy at payerpolicy.org for the complete list.

Code Description Coverage Status
C08.0–C08.9 Malignant neoplasm of other and unspecified major salivary glands Not Covered (Experimental)
C11.0–C11.9 Malignant neoplasm of nasopharynx Not Covered (Experimental)
C15.3–C15.9 Malignant neoplasm of esophagus Not Covered (Experimental)
+ 11 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.

The covered diagnosis — newly diagnosed supratentorial GBM — maps to C71.x (malignant neoplasm of brain) with supporting pathology documentation confirming WHO grade IV astrocytoma. Make sure your ICD-10 selection reflects the exact anatomical site and histologic confirmation required by the policy.


Get the Full Picture

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