This requests you to submit your personal comments to the Centers for Medicare and Medicaid (CMS) on their proposal to eliminate existing coverage for transcutaneous electrical nerve stimulation (TENS).

To submit your public comment to CMS click below:



On March 13, 2012, the Centers for Medicare and Medicaid (CMS) released a proposal to eliminate existing coverage of transcutaneous electrical nerve stimulation (TENS) for reducing chronic lower back pain (CLBP) after 90-days. They are seeking comments from physicians and other stakeholders on this proposal. The official comment period closes on April 12, 2012.

Without your help in providing comments on how useful TENS is for treating your patients with CLBP, this proposal will go into effect in June of this year and you will no longer be able to prescribe TENS for chronic lower back pain beyond 90 days unless your patient is one of the few participating in a government study.

As a regular prescriber of TENS or as a clinician who treats patients with chronic low back pain that benefit from this technology, I am calling on you for your help to ensure continued coverage of TENS and stop CMS from adopting this proposed National Coverage Decision (NCD) that would restrict existing TENS coverage for CLBP patients.

To prevent CMS from taking rash, unwise and uninformed action to eliminate this long-covered, cost-effective, clinically necessary, for your patients, CMS must hear from you by no later than THURSDAY, APRIL 12 regarding

  1. your experience with using TENS to effectively treat CLBP patients, especially those patients who continue to use TENS for pain relief beyond 90 days, and
  2. why your practice depends on continued existing coverage of TENS for treating your patients suffering from CLBP.

Adoption of the TENS NCD by CMS would be severe and potentially irrevocable. If CMS is allowed to restrict coverage of TENS for patients with CLBP, it would:

  1. Overrule your medical decision that TENS is appropriate to treat your patient’s chronic lower back pain;
  2. Eliminate patient access to care that has been approved by the FDA as safe and effective for CLBP for at least three decades and covered by Medicare for two decades;
  3. Establish precedent for future government action to eliminate coverage for other long-standing, cost-effective, and clinically necessary treatments on which you rely for treating your patients.
  4. Interferes with the doctor-patient relationship founded on the physician’s uncompromising commitment to patient welfare. By severely restricting treatment alternatives currently available to you in treating CLBP patients, the government is substituting its judgment for your judgment regarding the best treatment alternative for your patients.

Request for Action

We seek your help to protect existing TENS coverage so you and your colleagues will continue to have access to cost-effective, clinically necessary treatment options for your CLBP patients that have long been made available to you.

Specifically, I am asking that you please submit comments to CMS on or before THURSDAY, APRIL 12 regarding your experience with TENS in treating your CLBP patients and why, in your personal professional opinion, the federal government should not restrict coverage for TENS. You can submit your view to CMS by either:

  1. emailing CMS at CAGinquiries@cms.hhs.gov (be sure to insert subject line as “Proposed Decision Memorandum for Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain (CAG-00429N”) or
  2. submitting your comments directly by copying and pasting your comments directly into the comment box on the CMS NCD Website by doing the following:

    a. Go to CMS NCD Website for Proposed TENS Decision Memorandum CAG-00429N;

    b. Click, read, and check the “I have read and understand” box regarding CMS privacy posting policy (PHI);

    c. Copy and paste your comments into the comment box after providing your First Name, Last Name, and Email address.

    d. Provide your address, phone number, fax number, job title, and organization.

    e. Hit Submit

The proposed Decision Memorandum is available at http://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=256&fromdb=true.

Prepared by the Neurostimulation Device Alliance which includes the leading United States manufacturers and suppliers of electrical stimulation technologies and supplies. For more information on this importance access to care issue, please contact Thomas P. Hughes, J.D., 12400 Whitewater Drive, Suite 2010 Minnetonka, Minnesota 55343/651-269-5118/tomhughes99@gmail.com