Medica policy

Sacral Nerve Stimulation

Sacral Nerve Stimulation is a public Medica policy (effective Sep 1, 2026). It lists 12 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer: Medica
Effective: Sep 1, 2026
Line of business: Commercial, Medicaid
Source: partner.medica.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

Code	Other Medica policies
0786T	Policies naming 0786T
64561	Policies naming 64561
64581	Policies naming 64581
A4290	Policies naming A4290
L8679	Policies naming L8679
L8680	Policies naming L8680
L8684	Policies naming L8684
L8685	Policies naming L8685
L8686	Policies naming L8686
L8687	Policies naming L8687
L8688	Policies naming L8688
L8689	Policies naming L8689

All Medica policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.