Does Medicare Pay for a TENS Unit?

A Transcutaneous Electrical Nerve Stimulation (TENS) unit is a compact, battery-powered device designed to alleviate pain through the delivery of mild electrical currents. These units feature electrodes that adhere to the skin, sending electrical impulses to stimulate nerves. This therapy aims to modify pain signals or trigger the body’s natural pain-relieving chemicals. Medicare can cover TENS units as durable medical equipment (DME) under specific conditions.

Medicare Coverage Eligibility for TENS Units

Medicare coverage for a TENS unit is contingent upon it being deemed medically necessary by a physician. The unit must be prescribed for a specific chronic condition causing intractable pain, which means the pain has lasted for at least three months and has not responded to other forms of treatment. This requirement ensures that TENS therapy is considered only after conventional approaches have proven ineffective. Medicare does not cover TENS units for certain conditions, such as chronic low back pain, headaches, temporomandibular joint (TMJ) pain, or pelvic pain.

A physician’s written order is mandatory for Medicare to consider coverage, detailing the medical necessity and the anticipated duration of need. Typically, Medicare requires an initial trial period, usually 30 to 60 days, during which the TENS unit is rented to assess its effectiveness.

During this trial, the physician monitors the patient’s response to determine if the unit significantly improves pain levels. If the TENS unit proves beneficial, Medicare may then cover the cost of purchasing the device. It is important to obtain the TENS unit from a durable medical equipment supplier enrolled in and approved by Medicare. TENS units are specifically covered under Medicare Part B, which addresses outpatient medical services and supplies.

Steps to Obtain a Medicare-Covered TENS Unit

Obtaining a Medicare-covered TENS unit begins with a consultation with your physician. During this visit, you will discuss your chronic pain condition and whether TENS therapy is an appropriate treatment option for you. Your physician will document the medical necessity of the TENS unit.

Once medical necessity is established, your physician will provide a detailed written order for the TENS unit. This prescription is a crucial document that the durable medical equipment (DME) supplier will require before they can provide the unit.

You will then need to locate a Medicare-approved DME supplier, which can often be done through Medicare’s official website or by asking your physician for recommendations. This supplier will handle the rental of the unit for the initial trial period, typically 30 to 60 days. During this time, the supplier will submit the necessary claims to Medicare using your Medicare information and the doctor’s order. If the trial is successful, leading to the unit’s purchase, the supplier will facilitate the change in billing status.

Understanding Your Out-of-Pocket Costs

When Medicare covers a TENS unit, beneficiaries typically incur certain out-of-pocket expenses. Before Medicare begins to pay its share, you must first meet the annual Medicare Part B deductible. For 2025, this deductible is $257.

After the deductible has been satisfied, Medicare generally pays 80% of the Medicare-approved amount for the TENS unit, whether it is for rental during the trial period or for its eventual purchase. This means you are responsible for the remaining 20% coinsurance. For example, if the Medicare-approved amount for the unit is $100, Medicare pays $80, and you are responsible for $20.

It is important to ensure that the durable medical equipment supplier accepts Medicare assignment. A supplier who accepts assignment agrees to accept the Medicare-approved amount as full payment for the equipment, preventing you from being balance-billed for charges exceeding this amount. Supplemental insurance plans, such as Medigap policies, may help cover some or all of these out-of-pocket costs, including the deductible and coinsurance amounts.