Key facts for NCD 160.2
- Benefit category
- Physicians' Services
- Effective date
- 04/01/2003
- Implemented 04/01/2003
- Transmittal
- Transmittal 167
- Versions published
- 2
- Manual chapter
- 160
- NCD Manual (Pub. 100-03)
TL;DR
NCD 160.2 sets Medicare's national policy for treatment of motor function disorders with electric nerve stimulation under the benefit category "Physicians' Services", effective 04/01/2003 and implemented 04/01/2003. Where electric nerve stimulation is employed to treat motor function disorders, no reimbursement may be made for the stimulator or for the services related to its implantation since this treatment cannot be considered reasonable and necessary. It has been revised 1 time since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
While electric nerve stimulation has been employed to control chronic intractable pain for some time, its use in the treatment of motor function disorders, such as multiple sclerosis, is a recent innovation, and the medical effectiveness of such therapy has not been verified by scientifically controlled studies.
Indications and limitations of coverage
Where electric nerve stimulation is employed to treat motor function disorders, no reimbursement may be made for the stimulator or for the services related to its implantation since this treatment cannot be considered reasonable and necessary.
NOTE: For Medicare coverage of deep brain stimulation for essential tremor and Parkinson's disease, see § 160.24 of the NCD Manual.
Text reproduced from the CMS Medicare Coverage Database record for NCD 160.2 version 2. View the original on cms.gov.
Revision history
02/2003 - Noted that Medicare coverage for deep brain stimulation for essential tremor and Parkenson's disease can be found at §160.24 of the NCD Manual. Effective and implementation dates 04/01/2003. ( TN 167 ) (CR 2553)
03/1997 - Reflected that instruction related to electrical nerve stimulation does not apply to deep brain stimulation provided by an implanted stimulator device and is subject to Medicare coverage at carrier's discretion. Effective date 04/15/1997. (TN 93)
How this NCD shows up on remittances
A service denied under a National Coverage Determination returns CARC 50 (not deemed medically necessary) with remark N386 (decision based on an NCD); a denial citing a local policy instead carries N115. Because NCDs bind nationally, the appeal path is documentation that the patient meets the indications above, not a contractor-policy argument.
How QuickIntell applies NCD 160.2
QuickAuth checks the ordered service and diagnosis against NCD and LCD criteria before the encounter, QuickCode validates the diagnosis pairing on the claim, and QuickRCM routes CARC 50 denials with the policy text and the covered-code list attached so the appeal starts with evidence.
Frequently asked questions — NCD 160.2
What does NCD 160.2 cover?
Where electric nerve stimulation is employed to treat motor function disorders, no reimbursement may be made for the stimulator or for the services related to its implantation since this treatment cannot be considered reasonable and necessary. The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 160.2 take effect?
The current version (2) is effective 04/01/2003, implemented 04/01/2003, published in transmittal 167. CMS lists 2 versions of this NCD.
Does a Local Coverage Determination override NCD 160.2?
No. A National Coverage Determination binds all Medicare Administrative Contractors; an LCD can only address services or circumstances the NCD leaves open. Claims denied under this NCD typically return CARC 50 with remark N386 (NCD) rather than N115 (LCD).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.
- Medicare Coverage Database NCDs via the CMS Coverage APIVersion API snapshot 2026-09-27 · effective 2026-09-20 · file national-coverage-ncd.jsonSHA-256 a90fadfd264b9ef4…
Disclaimer
This page reproduces the CMS National Coverage Determination text and, for laboratory NCDs, the CMS ICD-10 edit lists, as an operational reference. Coverage decisions depend on the full policy, the claim and the contractor; nothing here is legal, clinical or billing advice. CPT codes are shown as numbers only; CPT descriptors are copyright AMA.