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Medical Policy Revision: Quantitative Sensory Testing

Effective January 24, 2018, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for quantitative sensory testing (QST) services.

Our medical policy, Quantitative Sensory Testing, identifies when QST is considered medically necessary or investigational.

We encourage you to review this policy in our Medical Policy Manual.


Based on the guidelines of our medical policy, Quantitative Sensory Testing, claims for services provided on and after January 24, 2018, regardless of the submitted diagnosis code(s), will be processed as noted below.

  • CPT® codes 0106T, 0107T, 0108T, 0109T, and 0110T submitted on claims for services provided to members enrolled in Horizon BCBSNJ Medicare Advantage (MA) plans will be denied as not medically necessary and non-covered services.
  • HCPCS code G0255 submitted on claims for services provided to members enrolled in Horizon BCBSNJ MA plans will be denied as experimental/investigational and non-covered services.
  • CPT codes 0106T, 0107T, 0108T, 0109T, and 0110T submitted on claims for services provided to members enrolled in Horizon BCBSNJ plans other than MA plans will be denied as experimental/investigational and non-covered services.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims on and after January 24, 2018.

CPT® is a registered mark of the American Medical Association.

Published on: October 25, 2017, 10:09 a.m. ET
Last updated on: September 11, 2020, 13:24 p.m. ET