Coverage is subject to the specific terms of the member’s benefit plan.
ESWT, high- or low-dose protocol or radial ECWT is considered experimental/investigational as a treatment for musculoskeletal conditions, including but not limited to:
- Plantar fasciitis; or
- Tendinopathies including tendinitis of the shoulder, tendinitis of the elbow (lateral epicondylitis), Achilles tendinitis, and patellar tendinitis; spasticity; stress fractures; delayed union; or
- Non-union of fractures; and avascular necrosis of the femoral head.
ESWT for all other indications is considered experimental/investigational and therefore, non-covered, because the safety/and or effectiveness of this service cannot be established by the available published peer-reviewed literature.