CMS Retires NCD 280.13 for TENS — What Billing Teams Need to Know About Policy Code NCD 273

The Centers for Medicare & Medicaid Services (CMS) has formally retired NCD 280.13, the longstanding National Coverage Determination governing Transcutaneous Electrical Nerve Stimulators (TENS) under policy code NCD 273. This retirement isn't a new development in terms of clinical coverage—the section was actually removed from the NCD Manual and folded into NCD 160.27 back in June 2012—but the administrative finalization of this change and its appearance in the March 2026 policy update cycle means billing teams and RCM directors need to confirm their documentation, cross-reference workflows, and claims routing are all pointed at the correct active policy.

What CMS Actually Changed in NCD 273 (Policy 280.13)

To understand why this matters operationally, it helps to know the history. Section 280.13 of the CMS NCD Manual originally housed CMS's national coverage policy for TENS devices billed as Durable Medical Equipment (DME). In June 2012, CMS consolidated TENS coverage guidance into NCD 160.27, effectively making 280.13 redundant.

The March 2026 update finalizes the administrative retirement of 280.13 and removes it from the NCD Manual entirely. The revision marker on this change—Rev. 11892, issued 03-09-23, effective 04-10-23—reflects when the retirement language was formally inserted, with the 2026 date representing the current policy cycle update that billing teams are seeing in their systems now.

The practical implication: if your team or your billing software has been citing NCD 280.13 as a policy reference for TENS claims, that citation is now pointing at a retired, empty section.

Where CMS TENS Coverage Actually Lives Now — NCD 160.27

The active Medicare coverage guidance for TENS devices sits in NCD 160.27. That's where CMS documents its coverage criteria for TENS used as a DME benefit, including indications, medical necessity standards, and any applicable limitations.

For billing teams that handle high volumes of DME claims for pain management practices or physical medicine groups, this is the policy you should be referencing on every TENS-related claim. If your payer policy library, charge master documentation, or prior authorization checklists still cite 280.13 as the governing NCD, those references need to be corrected immediately.

CMS also maintains two closely related policies that billing teams working with TENS should have on their radar:

• NCD 160.13 — Supplies Used in the Delivery of TENS and NMES (Neuromuscular Electrical Stimulation). This covers the consumable supplies—electrodes, lead wires, and similar items—billed alongside TENS devices.
• NCD 10.2 — TENS for Acute Post-Operative Pain. This is a separate coverage determination specifically for TENS use in the post-surgical setting, which has its own distinct criteria and is not governed by NCD 160.27.

If your practice bills TENS in a post-operative context, make sure your team is working from NCD 10.2—not NCD 160.27—for those encounters.

DME Benefit Category Implications for TENS Billing

TENS devices fall under Medicare's Durable Medical Equipment benefit category. That classification drives several downstream billing requirements that don't change with this retirement, but are worth reviewing any time a governing NCD is updated or restructured:

• DME MAC jurisdiction applies—claims route through the appropriate regional DME MAC, not the MAC processing Part B professional claims.
• Medical necessity documentation must align with the criteria in the active NCD (160.27) and any applicable LCD (Local Coverage Determination) from the relevant DME MAC.
• Supplier enrollment and accreditation requirements remain in place for any entity billing TENS devices as DME under Medicare.

The retirement of 280.13 doesn't introduce new coverage restrictions or change what TENS devices CMS will pay for. What it does do is eliminate a policy citation that should no longer appear anywhere in your billing documentation or denial management workflows.

Affected Codes

The policy data for NCD 273 (280.13 Retired) does not list specific CPT or HCPCS codes. This is consistent with the nature of this update—it is an administrative retirement and cross-reference consolidation, not a coverage criteria change that introduces or removes code-level coverage.

For the specific HCPCS codes applicable to TENS devices and supplies under Medicare, billing teams should reference:

• NCD 160.27 for TENS device coverage codes
• NCD 160.13 for TENS/NMES supply codes
• NCD 10.2 for post-operative TENS codes

Check the CMS Medicare Coverage Database directly for current code-level detail on each of those active policies, as code lists are subject to their own independent update cycles.

What Your Billing Team Should Do