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Extracorporeal Shock Wave Therapy denials: what the review data shows

Independent reviewers have decided 27 published cases where an insurer denied Extracorporeal Shock Wave Therapy — and they overturned the insurer 18.5% of the time. A denial for Extracorporeal Shock Wave Therapy is a starting position, not a final answer.

Published decisions
27
2001–2026
Overturned
18.5%
5 denials reversed

By condition

Published outcomes when Extracorporeal Shock Wave Therapy was denied for these conditions.
ConditionDecisionsOverturned
Plantar Fasciitis14
14.3%
How to use this in your appeal

These are outcomes from California’s external review program — an independent physician panel that binds the insurer. Every state has an equivalent process, and internal appeals succeed even more often. Cite the outcome record for Extracorporeal Shock Wave Therapywhen you appeal: reviewers routinely find that denials like yours didn’t hold up.

SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY

Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.

Denied Extracorporeal Shock Wave Therapy? 18.5% got it reversed.

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