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  • TRICARE Balks at Covering TENS and Dry Needling

    The TRICARE Health program used throughout the U.S. Department of Defense health care system has disallowed transcutaneous electrical nerve stimulation — TENS — as a reimbursable treatment for low back pain. And in another recent shift, the DoD agency that oversees TRICARE has decided that dry needling will not be covered if it's the sole purpose for a visit.

    The TENS decision was announced by the Defense Health Agency on February 26 and is effective June 1, 2020. In the notice of the change, the DoD says the TRICARE policy manual will now list TENS as an "unproven" treatment for low back pain and thus not eligible for coverage. Until now, TRICARE contractors were allowed to decide whether TENS was medically necessary for treatment of LBP.

    According to a recent article in Military.com, DoD arrived at its decision after reviewing multiple studies that found weak evidence for the effectiveness of TENS for LBP, with a TRICARE official telling the site that the findings indicated that "TENS for lower back pain is no more effective than … placebo."

    But the changes don't stop there. The revised TRICARE policy manual also lists dry needling as an "unproven" treatment — not just for LBP, but for any condition.

    The change means that TRICARE will not cover a PT visit if dry needling is the "sole purpose" for the session. This policy is effective immediately.

    TRICARE serves active duty and retired service members and their families worldwide.

    "APTA is disappointed in the Defense Health Agency’s decision and questions some of the evidence used to support its decision, and this doesn't change our commitment to advocating for coverage for these services across payers," said Kara Gainer, APTA's director of regulatory affairs. "Patient access to the most appropriate, evidence-based care and respect for the clinical decision-making skills of physical therapists remain at the heart of our policy efforts."

    Comments

    • Just another example of the ineffectiveness of the APTA.

      Posted by Anonymous on 3/7/2020 7:44 AM

    • Tens is useless and should not be covered!

      Posted by Chad Shafer on 3/7/2020 2:31 PM

    • Dry needling is an adjunct treatment and should not be the sole purpose of a PT visit. It is still not in the Practice Acts if many states.

      Posted by Laura on 3/7/2020 3:49 PM

    • Why not ask the thousands of patients that get relief from TENS UNITS everyday?

      Posted by Rebecca Pfeiffer on 3/7/2020 6:45 PM

    • My Chiropractor ( Dr. Mia Mcdougal) has been giving me accupunture or dry needling your the past 3 years to help me deal with lower back painfrom bone spurs. Medication doesn't help at all but he procedures do work...

      Posted by Thomas E Roberts on 3/7/2020 6:52 PM

    • Just another example of broken promises by DOD to service members. Non doctors making medication decisions to save money, disallowing treatments. More and more of this in Trump Administration.

      Posted by Winn315 on 3/7/2020 7:25 PM

    • I have been and still find significant relief from dry needle triggering. How can I find information on changing this?

      Posted by Lisa A Post on 3/7/2020 8:58 PM

    • What a crock. It has been proven treatment for lbp since they are kicking retired service members off base to get medical treatment. Everyone needs to call your confessional representatives and complain

      Posted by Brian Kuder on 3/7/2020 9:56 PM

    • To be fair, utilizing dry needling in isolation would be a poor clinic decision by anyone treating any condition and would not be best prqctice. Additionally, the research on TENS for low back pain is tenuous at best for long-term management and I would argue that it offers no more benefit that movement and heat. I honestly don't see a problem with Tricare's decision here as there are plenty of PTs out there that don't follow EBP and expect reimbursement for services that or no more effectual than alternatives.

      Posted by Anonymous on 3/7/2020 10:52 PM

    • Actually, TENS units do help. It may be a temporary fix but it sure as hell beats being pumped full of opioids. Having a severe back injury from having served, if it wasn’t for the TENS unit that I have at home, my quality of life would be far worse than it already is. WHY are people that don’t have specialty medical degrees, or a medical degree at all, deciding what a patient needs or doesn’t need? TRICARE? More like NOCARE!

      Posted by Terri Myre on 3/7/2020 11:40 PM

    • I this horrible I suffer from back pain as well as hip pain & have a tens unit , and it does help, and tricare is my family's coverage. Just another thing they are taking away from people who have chronic pain & really it the help, but they are great at raising the prices on the coverage that's for sure. It's just getting worse when it should be getting better the members & their families deserve Better!!!!

      Posted by Lisa Clark on 3/8/2020 1:07 AM

    • I am in disagreement with your decision to do away with TENS. I have had five (5) lower back surgeries. The TENS has helped immensely in relieving my lower back pain. Also, my hips and leg pain discomfort. I would love to have a unit before this is taken out of the system.

      Posted by Doreen Baclayon on 3/8/2020 5:07 AM

    • Very surprising as they paid over $700 for my unit back in 2003 when they were very expensive. I used it with a great deal of success for almost an entire year until I started having skin issues from the adhesive. I guess it was ok for the Tricare East administrator back then.

      Posted by Kathryn S on 3/8/2020 8:38 AM

    • This is ridiculous. They insist you go to physical therapy before surgery or anything else, but now they're limiting what can be done to help you in physical therapy. Again, another example of how the insurance companies run things not the doctors but the insurance companies.

      Posted by Anonymous on 3/8/2020 9:32 AM

    • As a chronic pain sufferer, I go to PT twice a week for pain management. It’s what helps me the most in keeping pain under control. I have been given prescriptions for opioids for break through pain, which I use in limited amounts, and focus on techniques taught by PT. Since new company in place, harder and harder to get approved to go to PT, now they limit what can be done there? It’s like they want us all to be opioid addicts vice managing pain in any meaningful way! Way to go Tricare!!

      Posted by Jill Edison on 3/8/2020 9:42 AM

    • What idiots!!!! Tens units have been used effectively! Also for many many years! This makes me sick!!!!!!!!’

      Posted by Kristi on 3/8/2020 9:53 AM

    • It's kind of a throwback from the 70's it was disgusting then and it's disgusting now just what things were taking off for the better they decide to k then and renege on their promise that could be expected.

      Posted by Wayne Dickey on 3/8/2020 10:44 AM

    • The War on the soldier continues.All chiro.’s Use it to relax muscles before an adjustment.It also offers relief at home.Ask any one with back pain.Number crunchers know nothing but numbers.Despite the fact some may suffer,if they are told to make it look like a waste that’s what they get paid for.Same holds true for some obscure medical panel convened to spout what the bosses say the outcome should be....or else.

      Posted by Mark Rosenberg on 3/8/2020 11:32 AM

    • TriCare will do everything they can NOT to treat pain for service members!! They just can not see the benefits, all they can see it ways to save the Government money at the expense of the Vets and their families to suffer even more!! So, more and more suicides will continue to take place why thank you try care for that you don't care anything about the people that served this country.

      Posted by Freda Lovell on 3/8/2020 2:43 PM

    • Dry needling absolutely works! Worked on my plantar fascia, which helped alleviate pain due to a spur on my heel. Although I have Tricare, I paid for it out of pocket due to it not being covered. It was like night and day difference in helping me recover and return to activities I love.

      Posted by Tricia Halliburton on 3/8/2020 5:16 PM

    • Welcome to the original socialized medicine! 😡🤬

      Posted by Kimberley on 3/8/2020 6:37 PM

    • Fir those of you who are eligible for VA benefits at a VA Hospital or clinic, they have TENS units for those who need them. That"s where I recieved mine. Besides TENS and dry needling, I am retired from the USAF and get my treatment care through Johns Hopkins U.S. Family Health Care. The other day,cI had an appointment with my Dermatiligist to get some pre-cancerous lesion burnt off. They can't even burn off lesions using liquid nitrogen without prior approval from my insurance carrier. What a wasted trip going their and having nothing done. So about a week later I got a call from my Doctors Office stating they got the authorization to do it. So now, I need to take time off from work to go see them for something they could if done on my previous appointment. I have been going to this Doctor for over a year and the insurance companies seem as though they want to pick and choose what you can or cannot get done. Totally rediculous.

      Posted by Oliver S.Ewing on 3/8/2020 7:37 PM

    • I'm retired Air Force 20yrs active duty. And when I joined I was told we would have health care for life. Well I have to say that is the biggest lie vfc in American history. Ever since I retired I have seen my benefits being pissed away by the very Government that I swore an oath to protect. I believe in the oath that I took to protect the Constitution against all enemies foreign and domestic and hold true allegiance to that oath. But to the idiot's that are running this country shame on you, the day will come when you are judged for the actions that they take against the American people.

      Posted by Bryan Kilgore on 3/8/2020 8:06 PM

    • There is not a simple answer here, as TENS units do not show clinical significant changes so denying reimbursing for such services are understandable. One hope by insurance companies is to save money for treatment that does not carry over to true pathological gains/changes, hopefully causing clinicians to provide more effective treatment.....other side of this is still reimbursing for opiods.....not much difference, as both are temporary fixes and both can affect pain levels. Allowing 10 (arbitrary number) units of modalities throughout a POC, we don't always need to make a black and white decision. But the PT profession needs to do better by providing proper diagnosis and therefore treatment. We have a DPT for a reason, stop trying the same treatment for everyone with back pain, don't treat pain (it's a symptom), diagnose the true cause. (Stepping off soap box now)

      Posted by jeff on 3/9/2020 12:50 PM

    • TENS $40 direct to patient. Education remains reimbursable and is our most versatile tool. It’s not Physical Therapy when only one modality of intervention is applied. We offer this service as self pay. Cannot disagree with the DN reimbursement limitation. No goals, clinical decision making, or EBP model applied then again not consistent with “PT”.

      Posted by Joe Grabicki on 3/10/2020 8:24 PM

    • The real question is what is the harm compared to the other care methods, NSAIDs and opiods? Both DN & TENS are less harmful. Allow for a trial & check for effectiveness like most insurances do for a RFA (most require a MBB before as a test).

      Posted by Anonymous on 3/25/2020 11:35 AM

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