Insurance coverage for stellate ganglion blocks

Insurance Coverage for Stellate Ganglion Blocks

Insurance does not generally cover stellate ganglion blocks for mental health. The procedure is well established, but generally only covered for use in pain conditions (and even then it may not be consistently covered). It remains an excellent treatment option — especially considering its effectiveness and durability.

Insurance

The stellate ganglion block (SGB) is a very old nerve block, originally described in the 1920s and then developed for use in the 1930s. 1

SGBs are more likely to be covered by insurance for some pain conditions, including:

  • Complex Regional Pain Syndrome (CRPS) of the upper extremity
  • Other pain, including pain from traumatic injury, in the upper extremities
  • Vasoplegia of the upper extremity, more commonly known as Raynaud’s syndrome
  • Refractory ventricular tachycardia

The first original reports of SGBs for mental health were from the 1940s for depression and, more recently, in 1990 for PTSD. 2

SGBs are used most often for treating trauma and may be useful in mental health for:

  • PTSD, and other trauma-related conditions
  • Anxiety, especially anxiety disorders with a significant physical component
  • Depression, in some cases
  • Insomnia, based on preliminary research
  • Long covid, based on preliminary research

Despite their long history, SGBs are generally unlikely to be covered for mental health treatments.

What Now?

We work to keep our treatments at Wells Medicine cost-effective. This is especially the case when considering the effectiveness and durability of SGB treatments.

You may choose to seek reimbursement from your insurance provider directly, or to do so with help from a third party billing company. We’re glad to provide you with documentation, including a superbill, which can help with these efforts.

We work with foundations to provide coverage for stellate ganglion blocks for those with financial need, and for veterans.

Outside of Wells Medicine, veterans may also find that some VAs and Tricare-based organizations will provide coverage for stellate ganglion blocks.

The future of Insurance Coverage for SGB

The more that patients demand and ask for coverage from their insurance providers, and the more research that can be done on the treatment using SGBs, the more likely it is that stellate ganglion blocks will be covered to treat mental health conditions, such as PTSD, in the future. Mental health care is not well-covered by insurance, across the board. However, insurance is a quickly changing landscape with respect to all sorts of things, including premium costs, coverage limitations, private insurance alternatives, and a growing self-pay network of providers.

Some concerted efforts on SGBs may improve the likelihood of insurance coverage, or there may be some broader changes in the way insurance covers mental health and SGB specifically. Pressure by patients and providers may help. In the meantime, the treatment is increasingly available from excellent providers and can be an excellent value while providing substantial relief for many people.

Additional Resources

Learn more about stellate ganglion blocks with another blog post or on our treatment page.

Learn more about why Wells Medicine does not take insurance and resources for pursuing coverage on your own.

About Us

Wells Medicine is a Houston-based practice designed to provide meaningful care for mental health. Providing targeted interventional treatments for Depression, Anxiety, OCD, PTSD and other conditions, with Ketamine Treatments, Stellate Ganglion Blocks, TMS, and Nitrous-Oxide Treatments. Focused on comprehensive care and integration with Psychiatry, Psychology, and Support Services. We are evidence-based, patient-focused and mission-driven.

The content here is for informational purposes and should not be relied upon for medical decisions. For the details of your specific medical conditions and treatments consult your doctors or other qualified healthcare professionals.

References

1. P. Prithvi Raj, Leland Lou, Serdar Erdine, Peter S. Staats, Steven D. Waldman, Gabor Racz, Michael Hammer, David Niv, Ricardo Ruiz-Lopez, and James E. Heavner, Interventional Pain Management: Image-Guided Procedures (Philadelphia: Elsevier Health Sciences, 2008)

2. J. Kerzner, H. Liu, I. Demchenko, D. Sussman, D. N. Wijeysundera, S. H. Kennedy, K. S. Ladha, and V. Bhat, “Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape,” Chronic Stress (Thousand Oaks) 5 (December 8, 2021): 24705470211055176, https://doi.org/10.1177/24705470211055176.