Insurance Information

AETNA - Aetna's Clinical Policy Bulletin states: “Aetna considers eye movement desensitization and reprocessing (EMDR) therapy medically necessary for the treatment of post-traumatic stress disorder (PTSD).”

Blue Cross Blue Shield - Blue Cross Blue Shield of North Carolina determined on August 28, 2006 that EMDR is acceptable treatment for PTSD.  Posted 9/1/06
                                               Blue Cross Blue Shield of Texas works with the Behavioral Health vendor, Magellan Behavioral Health, Inc.^TM, which adopted the American Psychiatric Association clinical practice guidelines.

CIGNA Behavioral Health – CIGNA follows the American Psychiatric Association (APA) Guidelines for the treatment of Acute Stress Disorder and Posttraumatic Stress Disorder. These guidelines accept EMDR for treatment. (CIGNABehavioral.com - Practice Guidelines for Behavioral Health Practitioners). 

Magellan Health Services Approves EMDR - Magellan’s Clinical Practice Guideline dated February 21, 2006 states that “EMDR has been found to be about as effective as other modalities for reducing symptoms of PTSD…”  It also says that “EMDR may provide relief earlier than other modalities; and may be tolerated better than ET (Exposure Therapy) by some patients.”  Magellan follows the APA Guidelines. Updated 5/9/06.

TRICARE – TRICARE Management Activity, the U.S. Department of Defense military health system, does not currently accept EMDR despite the Clinical Practice Guideline of the Department of Veterans Affairs & Department of Defense.  At EMDRIA’s request in 2005, TRICARE did a review of EMDR for the treatment of PTSD and concluded that the treatment was “unproven”.  In April 2006, TRICARE  agreed to do a “more in-depth review, but in an August 31, 2006 policy document TRICARE said that "EMDR is not psychotherapy". 

United Behavioral Health (UBH) - UBH has published its Best Practice Guidelines 2006 which for the treatment of PTSD refer to the American Psychiatric Association (APA) Guidelines. UnitedHealth Group, through its affiliate UnitedHealth Military & Veteran's Services LLC (UMVS), is contracted with the Department of Defense to provide Managed Care Support Services in the TRICARE SOUTH Region effective April 1, 2011. This involves the following states: AL, AR, GA, KY (Fort Campbell only), LA, MS, OK, SC, TN, TX (excluding El Paso) and FL. Updated 6/3/10

Wellmark BlueCross Blue Shield of Iowa - Wellmark has agreed to accept EMDR for the treatment of PTSD according to a July 18, 2007 letter to EMDRIA Member Suzanne Zilber. “A review of the available body of evidence has convinced Wellmark’s medical directors that EMDR therapy for the treatment of PTSD may be considered a medically necessary and useful technique to facilitate reprocessing of traumatic experience,” Wellmark said in the letter. “Wellmark will begin the process to update the Behavioral Health Provider Guide to indicate that up to 10 sessions of EMDR, up to one hour long,” will be allowed. Posted 7/20/07

This information above is what has been obtained by EMDRIA. Please send any insurance coverage updates to Scott Blech.

Clinical Guidelines

APA Guidelines - The American Psychiatric Association has released Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder. EMDR is given the same status as CBT as an effective treatment for ameliorating symptoms of both acute and chronic PTSD.

Australian Guideline for PTSD - Published in 2007 by the Australian Centre for Posttraumatic Mental Health.  The Guidelines state that “adults with PTSD should be provided with trauma-focused interventions (trauma-focused cognitive behavioural therapy [CBT] or eye movement desensitization [EMDR] and reprocessing, in addition to in vivo exposure).

Clinical Guideline for PTSD - Published in March 2005 by the UK ’s National Institute for Clinical Excellence.  This guideline (pdf file) explicitly 'warns' clients to not use other treatments than trauma focused CBT or EMDR. There is also a Power Point slide show available to spread the good news.

Cochrane Reviews 2007 - There was evidence that EMDR, individual Trauma-focused cognitive behavioral therapy/exposure therapy (TFCBT), stress management and group TFCBT are effective in the treatment of PTSD. Other non-trauma focused psychological treatments did not reduce PTSD symptoms as significantly. There was some evidence that individual TFCBT and EMDR are superior to stress management in the treatment of PTSD at between 2 and 5 months following treatment, and also that TFCBT, EMDR and stress management were more effective than other therapies. Cochrane Database of Systematic Reviews 2007.

Department of Veterans Affairs & Department of Defense, Washington, DC (2004) -  VA/DoD Clinical Practice Guideline for the Management of Post-Traumatic Stress. EMDR was one of four therapies given the highest level of evidence and recommended for treatment of PTSD.

Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies (2008). EMDR was ranked as an evidence-based, Level A treatment for PTSD in adults.