Is Neurofeedback Covered by Insurance?

Is neurofeedback covered by insurance?
In most cases, no. Medicare, Medicaid, and many private insurers classify neurofeedback as experimental and do not provide coverage. However, some private insurance plans may reimburse it if billed under biofeedback or combined psychotherapy codes, depending on the diagnosis, coding, and documentation.

Key Points

• Neurofeedback is usually not covered by insurance.

• Some private insurers may reimburse when billed under biofeedback codes.

• Coverage depends on diagnosis, documentation, and coding strategy.

• Providers often issue superbills for out-of-network reimbursement attempts.

• Patients should confirm preauthorization and request a letter of medical necessity.

Why Most Insurers Don’t Cover Neurofeedback

Insurance companies often classify neurofeedback as experimental or investigational. Although research supports its effectiveness for conditions like ADHD, anxiety, PTSD, and sleep disorders, insurers argue that evidence is not yet strong enough to make it a standard covered treatment.

Medicare and Medicaid, in particular, are strict: they may reimburse biofeedback for certain physical conditions (such as urinary incontinence or chronic pain) but rarely for neurofeedback targeting mental health or cognitive issues.

Billing Codes and Reimbursement Possibilities

While there is no unique CPT code specifically for neurofeedback, providers often attempt reimbursement using these codes:

• 90901 – Biofeedback by any modality.

• 90875 – Biofeedback combined with 25–35 minutes of psychotherapy.

• 90876 – Biofeedback combined with 45–50 minutes of psychotherapy.

Some insurers accept these codes, but approval depends on how the provider documents the treatment and whether the insurer views it as medically necessary. Even when reimbursement is granted, payments are often low.

Variability Between Insurers

Not all insurance companies have the same stance.

• Medicare and Medicaid: Generally exclude neurofeedback, except in rare biofeedback cases.

• Private insurers: Companies like Aetna, Cigna, and UnitedHealthcare may reimburse in very specific cases, usually when biofeedback is medically necessary for conditions like migraines or anxiety.

• Employer-sponsored plans: Some larger employers include behavioral health coverage that may allow neurofeedback under flexible coding.

• Medicare Advantage plans: Rarely, certain Advantage plans include coverage, but this is the exception, not the rule.

Patient and Provider Experiences

In practice, many providers do not accept direct insurance billing for neurofeedback. Instead, they offer superbills—detailed invoices with CPT and diagnostic codes—so patients can submit claims themselves. Success depends on the plan and often requires persistence.

Patients frequently report:

• Partial reimbursement once their deductible is met.

• Coverage for therapy sessions, but not for brain mapping (qEEG), which is typically billed separately.

• Denials when insurers determine neurofeedback is “not medically necessary.”

Costs Without Insurance

Since insurance rarely pays, patients often ask about out-of-pocket costs. On average:

• Initial brain mapping (qEEG): $250–$500.

• Single neurofeedback session: $80–$200.

• Total program: Many treatment plans require 20–40 sessions, leading to total costs of $2,000–$8,000 or more.

Some clinics offer package deals or financing to make treatment more affordable.

Conditions Where Coverage Is More Likely

Although rare, insurance may cover neurofeedback when:

• ADHD treatment is recommended by a psychiatrist and billed under biofeedback codes.

• Migraines or chronic pain are being managed with biofeedback strategies.

• Anxiety or PTSD are addressed under combined psychotherapy-biofeedback sessions.

Success requires thorough documentation, a provider’s letter of medical necessity, and preauthorization.

How to Improve Chances of Coverage

Patients and providers can take several steps to increase the likelihood of reimbursement:

1. Use the correct CPT codes (90901, 90875, 90876).

2. Request preauthorization from the insurance company before starting treatment.

3. Provide medical documentation: A detailed diagnosis and a provider’s letter of medical necessity.

4. Submit superbills if the provider does not bill insurance directly.

5. Appeal denials: Patients can request reconsideration if coverage is denied, especially if strong documentation supports the medical need.

Frequently Asked Questions (FAQ)

Q1: Why is neurofeedback not widely covered?
Because many insurers classify it as experimental, despite growing evidence of effectiveness.

Q2: Can neurofeedback be billed under standard therapy codes?
Yes, sometimes under psychotherapy plus biofeedback codes (90875, 90876), but reimbursement is inconsistent.

Q3: Are there any insurance success stories?
Yes, but limited. Some patients with employer-sponsored insurance or private plans have received partial reimbursement, especially for ADHD or anxiety.

Q4: Is brain mapping (qEEG) ever covered?
Rarely. Even when neurofeedback sessions are reimbursed, brain mapping is usually considered diagnostic and billed separately, making coverage unlikely.

Q5: What’s the best way to confirm coverage?
Call your insurance company, provide the CPT codes, and ask if services are covered under your plan for your specific diagnosis.

• Step 1: Contact your insurance company and ask directly about CPT codes 90901, 90875, and 90876.

• Step 2: Request a letter of medical necessity from your clinician.

• Step 3: Submit a preauthorization request before starting therapy.

• Step 4: If denied, ask for a superbill to seek out-of-network reimbursement.

• Step 5: Explore package pricing or financing if self-pay is necessary.