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Prolotherapy and Sclerotherapy (CPB 0207, reviewed 2026-03-27)
Aetna·Effective Mar 27, 2026
Aetna has updated its prolotherapy and sclerotherapy policy (CPB 0207, effective 2026-03-27) to clarify that prolotherapy is considered experimental/investigational for ALL indications including common musculoskeletal conditions (back pain, knee osteoarthritis, tendinopathy, plantar fasciitis, etc.). Sclerotherapy remains covered only for specific clinical indications (varices, hemorrhoids, cysts, malformations). Billing teams must ensure claims for prolotherapy procedures are not submitted as covered services and must verify sclerotherapy indications meet strict medical necessity criteria before processing.