Based on the evidence reviewed in BrainFutures’ report NeuroFeedback: An Efficacious Treatment for Behavioral Health, neurofeedback (NFB) should be considered a first-line treatment option for ADHD, as well as an effective intervention for anxiety. Some studies have even found NFB to be as efficacious as stimulant medication for treating ADHD with better results at 12-month follow-up, making it a particularly attractive options for patients and families concerned about the long-term use of stimulants, or for those ADHD patients that experience significant adverse side effects from these medications. And, for those with anxiety, the evidence points to NFB as a valid treatment option effective in reducing anxiety symptoms.
NFB has had a Category I Common Procedural Technology (CPT) medical procedure code since 1978, and many reputable provider groups acknowledge and/or recommend NFB as a valid treatment modality.
Can NFB be Billed to Insurance?
In several states, insurance companies and Medicaid plans cover NFB as a treatment, while in others, coverage depends on case-by-case approval. Currently, dozens of hospitals and medical centers, including many VA hospitals, offer or cover NFB as a standard treatment.
Established CPT billing codes allow NFB to be billed to insurance as a standalone treatment or as component of psychotherapy. The current standalone code is the same code for biofeedback: 90901. Practitioners may also use mental health codes for sessions that combine NFB with therapy or counseling: 90875 for a 25-minute session and 90876 for a 50-minute session.
Several insurance companies accept NFB CPT codes, others may be restrictive based on associated diagnostic codes, and still others may evaluate reimbursement on a case-by-case basis.
Currently NFB is mandated to be offered at all VA centers as part of their Whole Health Initiative – a veteran-directed wellness program. More than 26 VAs, hospitals and major medical centers offer NFB onsite.
NFB is covered in at least 12 states by various insurance plans including Carefirst, Tricare, United Health, Aetna, Cigna, and Kaiser Positive Choice, to name a few. Additionally, in several states NFB is reimbursable by Medicaid.
The trend is moving towards a broader inclusion of NFB in the behavioral health and brain fitness treatment toolboxes. Currently, the possibility of a unique CPT code for NFB (not just biofeedback more broadly) is being explored; and more recently, the American Psychological Association recognized biofeedback and psychophysiology as a proficiency in professional psychology.11 This should further pave the way for greater acceptance and inclusion of NFB as an efficacious treatment for ADHD and other conditions and symptoms. However, broader adoption is needed, and providers can leverage BrainFutures’ report, including a summary of evidence to help educate insurers about NFB’s effectiveness and research base.
American Psychological Association. (2019). Biofeedback and Applied Psychophysiology. Retrieved from https://www.apa.org/ed/graduate/specialize/biofeedback