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Insurance Coverage 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 in August 2008 that EMDR is acceptable treatment for PTSD.  Posted 8/08
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, covers EMDR for the treatment of PTSD in adults.  TRICARE changed its psychotherapy treatment policies to cover EMDR on November 3, 2010 with an effective date retroactive to April 16, 2007. EMDRIA began its efforts to gain TRICARE in 2005.

United Behavioral Health (UBH)

UBH has published its Best Practice Guidelines 2009 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's Behavioral Health Guide (updated October 2010) "allows benefits for up to 10 one hour-sessions of EMDR for the treatment of post tramatic stress disorder (PTSD), provided the services are medically necessary. Services for EMDR therapy are considered individual psychotherapy and should be billed using procedure codes 90804 – 90807."  Updated 2/2011

*This information above is what has been obtained by EMDRIA. Please send any insurance coverage updates to Mark Doherty.

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