Coverage of Conditions and Treatments (Coverage Decisions)

Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.

List also available in PDF format.

Archived Coverage Decisions.

See Treatment Guidelines and Resources for additional information.

Extracorporeal shock wave therapy (ESWT) is a noninvasive treatment for various chronic musculoskeletal disorders, such as plantar fasciitis and tendinopathies. It involves delivery of intense and short energy waves (shock waves) to the affected region with the objective of reducing pain and promoting healing of the soft tissue.

Coverage decision: Not Covered

Extracorporeal Shock Wave Therapy (ESWT) is not a covered benefit for musculoskeletal conditions.

The HTCC reviewed the evidence on ESWT for musculoskeletal conditions in March 2017 meeting. A majority of members considered ESWT unproven for efficacy and cost-effectiveness. The committee voted to not cover ESWT. Complete information on this HTCC determination is available here: What we're working on | Washington State Health Care Authority.

In adopting this HTCC coverage determination, the Department has concluded that the determination does not conflict with any state statute. Any coverage for investigational treatment would be considered per WAC 296-20-02850. Any coverage for health technologies that have a FDA Humanitarian Device Exemption status would be considered per RCW 70.14.120 (1) (b).