When Innovation Meets Coverage Rules: P-Stim, TENS, and Coding Integrity

Episode Summary

In this Deep Dive, we examine the May 2026 P-Stim billing issue and what chiropractic practices should learn from it. This episode is not an indictment of electrical stimulation, TENS, ancillary services, cash-based care, vendors, or innovation. The issue is narrower: the billing code must match the service performed.

Electrical stimulation has helped many patients and remains an important conservative care tool when clinically appropriate, clearly documented, and accurately billed. TENS and standard e-stim are not the issue. The P-Stim cases focused on allegations that surface-applied auricular stimulation devices were billed under codes intended for surgically implanted neurostimulators, creating a major c ...