Note: Up to 12 visits (generally given 2 times a week for 6 weeks) are considered medically necessary initially. ![]() Vestibular rehabilitation is considered experimental and investigational for all other indications because its effectiveness for indications other than the one listed above has not been established. The member has failed medical management (e.g., use of vestibular suppressant medications to reduce symptoms).The member has confirmed diagnosis of a vestibular disorder or has undergone ablative vestibular surgery and.Symptoms (e.g., vertigo and imbalance) have existed for more than 6 months and.For individuals with these diagnoses and all other indications, use of the Epley maneuver or the Semont maneuver is considered experimental and investigational.įor chronic vertigo / persistent postural perceptual dizziness (PPPD) when all of the following criteria are met: ![]() The Epley maneuver and the Semont maneuver have not been demonstrated to be effective in persons with disorders of the central nervous system such as temporal lobe epilepsy, multiple sclerosis, cerebrovascular disease, vertiginous migraine, cerebellopontine angle tumors, and primary or metastatic cerebellar lesions, based on neurological examination, magnetic resonance imaging, or history.
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