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​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Low-Level Laser Therapy
07.00.14i

Policy

Coverage is subject to the terms, conditions, and limitations of the member's contract.

MEDICALLY NECESSARY

Low-level laser therapy (LLLT) is considered medically necessary, and, therefore, covered for prevention of oral mucositis in individuals who are undergoing cancer treatment that is associated with an increased risk of oral mucositis (e.g., chemotherapy and/or radiotherapy and/or hematopoietic stem cell transplantation).

EXPERIMENTAL/INVESTIGATIONAL

LLLT for all other conditions and LLLT with dynamic photonic and thermokinetic energy is considered experimental/investigational and, therefore, not covered, because the safety and/or effectiveness of this service cannot be established by review of the available published peer-reviewed literature. This includes, but is not limited to, when low-level laser therapy is used for the following conditions:

  • Carpal tunnel syndrome
  • Neck pain
  • Subacromial impingement
  • Adhesive capsulitis
  • Temporomandibular joint pain
  • Low back pain
  • Osteoarthritis
  • Heel pain (i.e., Achilles tendinopathy, plantar fasciitis)
  • Rheumatoid arthritis
  • Bell palsy
  • Fibromyalgia
  • Wound healing
  • Lymphedema
  • General joint pain
  • Toxic joint syndrome
  • Psoriatic arthritis
  • Knee pain
  • Plica syndrome
  • Osgood-Schlatter disease
  • Patellofemoral syndrome
  • Gout
  • Lupus
  • Plantar fasciitis
  • Tennis elbow
  • Occipital myospastic​ headaches
  • Tension headaches
  • Muscular headaches
  • Rotator cuff injuries
  • Major depressive disorder
  • Alzheimer disease
BILLING REQUIREMENTS

Using the Current Procedural Terminology (CPT) procedure code 97026 (infrared therapy) or any other code to report cold laser/low-level laser therapy is a misrepresentation of the actual service rendered. These services are subject to post-payment review and audit procedures.

Inclusion of a code in this policy does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

Guidelines

BENEFIT APPLICATION

Subject to the terms and conditions of the applicable benefit contract, low-level laser therapy, when used for the prevention of oral mucositis, is covered under the medical benefits of the Company's products when the medical necessity criteria listed in this medical policy are met. However, services that are experimental/investigational are a benefit contract exclusion for all products of the Company. Therefore, they are not eligible for reimbursement consideration.

US FOOD AND DRUG ADMINISTRATION (FDA) STATUS

There are numerous lasers approved by the FDA for low-level laser therapy.

Description

Low-level laser therapy (LLLT), also known as transcranial photobiomodulation therapy or cold laser therapy, refers to the use of polarized red-beam or near-infrared light to provide pain relief for various acute and chronic conditions. In contrast to more powerful surgical lasers, LLLT has low power, usually 5 to 500 milliwatts with wavelengths of 600 to 1000 nanometers. When applied to the skin, LLLT does not burn and produces little or no sensation. Whereas the exact mechanism of its effect is unknown, it is hypothesized that the cold laser light energy penetrates into tissues, stimulating the cellular and extracellular systems (e.g., neurologic, vascular, immune, lymphatic), increasing serotonin levels with resultant pain relief and/or accelerated healing.

Smart Laser (Willow Curve) is a newly developed advanced medical technology designed to relieve joint pain with thermal and photonic energy residing in the category of LLLT. The photonic and thermal kinetic energies stimulate 15 biophysiological processes for treating the joint and surrounding tissues by dilating blood vessels and increasing lymphatic flow to reduce swelling, slowing nerve response time and releasing endorphins reducing the perception of pain, blocking specific pain receptors to promote pain relief and detoxifying by removing toxic debris from the joints increasing the circulation. However, no published peer-reviewed literature was identified to support the use of LLLT with dynamic photonic and thermokinetic energy.

LLLT uses low-power lasers and light-emitting diodes in the far-red to near-infrared optical region to penetrate brain tissues and enhance adenosine triphosphate (ATP) biosynthesis, regulate mitochondrial homeostasis, enhance serotonin and dopamine levels in the brain, and facilitate neurogenesis and/or neuroplasticity proposed for the treatment of depression and Alzheimer disease. Preliminary clinical study evidence explores the potential use of LLLT for major depressive disorder; however, future studies are needed to clarify ideal stimulation parameters and the overall efficacy, effectiveness, and safety of this treatment. The evidence is insufficient to determine the effects of the technology on health outcome.


The evidence for LLLT in individuals who have increased risk of oral mucositis (OM) due to some cancer treatments (e.g., chemotherapy, radiotherapy) and/or hematopoietic stem cell transplantation includes randomized controlled trials (RCTs) and systematic reviews of RCTs. Relevant outcomes are symptoms, morbid events, quality of life, and treatment-related morbidity. Studies included individuals undergoing various cancer chemotherapy regimens or hematopoietic stem cell transplantation. A recent systematic review of RCTs on low-level laser for prevention of OM included 18 RCTs, generally considered at low risk of bias, and found statistically significantly better outcomes with LLLT than control conditions on primary and secondary outcomes. In addition, three double-blind RCTs published in 2015 found significantly better outcomes in individuals undergoing LLLT than undergoing sham treatment prior to or during cancer treatment. The evidence is sufficient to determine qualitatively that the technology results in a meaningful improvement in the net health outcome.


In 2020, Peng et al. performed a meta-analysis involving 30 studies comparing prophylactic and therapeutic LLLT to placebo or no therapy in reducing the risk of severe OM in individuals receiving chemotherapy or radiotherapy. The authors determined that prophylactic and therapeutic LLLT can reduce the risk of severe OM in individuals receiving chemotherapy or radiotherapy.


In an experimental, prospective double-blind RCT in 2019, Maŕ​in-Conde et al. conducted a study among 26 individuals diagnosed with oral squamous cell carcinoma undergoing oncological treatment. The objective of the study was to assess the effectiveness of photobiomodulation with LLLT as a preventive and therapeutic procedure for the treatment of oral and oral pharyngeal mucositis caused by radiochemotherapy in individuals diagnosed with oral squamous cell carcinoma. The study showed that photobiomodulation with LLLT reduced the incidence and severity of mucositis in individuals treated with radiotherapy and chemotherapy.

​

The evidence for LLLT in individuals who have orthopedic pain (i.e., neck pain, osteoarthritis knee pain, low back pain, carpal tunnel syndrome) includes RCTs and, for some indications, systematic reviews of RCTs. Relevant outcomes are symptoms, functional outcomes, quality of life, and treatment-related morbidity. Findings of the RCTs were mixed and had methodologic limitations. The evidence is insufficient to determine the effects of the technology on health outcome.


In 2020, Martimbianco et al. performed a meta-analysis to determine the benefits and harms of LLLT for Achilles tendinopathy. Four trials involving 119 individuals were analyzed. The certainty of evidence was low to very low, low, and the results were insufficient to support the routine use of laser therapy for Achilles tendinopathy.​
The evidence for low-level laser therapy in individuals who have shoulder conditions, heel pain, or temporomandibular joint pain includes RCTs and, for some indications, systematic reviews of RCTs. Relevant outcomes are symptoms, functional outcomes, quality of life, and treatment-related morbidity. Findings of the RCTs were mixed and had methodologic limitations. The evidence is insufficient to determine the effects of the technology on health outcome.

The evidence for LLLT in individuals who have bone, ligament, and joint conditions (e.g., rheumatoid arthritis, fibromyalgia) includes RCTs and, for some indications, systematic reviews of RCTs. Relevant outcomes are symptoms, functional outcomes, quality of life, and treatment-related morbidity. Findings of the RCTs were mixed and had methodologic limitations. The evidence is insufficient to determine the effects of the technology on health outcome.

The evidence for LLLT in individuals with Bell palsy includes an RCT. Relevant outcomes are change in disease status, functional outcomes, quality of life, and treatment-related morbidity. Bell palsy may completely resolve within months and, thus, it is difficult to determine improvements from laser therapy over the natural resolution of the illness. The available RCT did not include a sham treatment; LLLT was superior to exercise only in this study. Sham-controlled studies are needed as well as additional studies comparing LLLT with alternative Bell palsy treatments. The evidence is insufficient to determine the effects of the technology on health outcome.

The evidence for LLLT in individuals who have lymphedema includes RCTs, observational studies, and systematic reviews. Relevant outcomes are symptoms, functional outcomes, quality of life, and treatment-related morbidity. Systematic reviews of RCTs and observational studies found methodologic flaws in the available studies and have not consistently found better outcomes in individuals receiving LLLT than in individuals receiving a control condition treatment. The evidence is insufficient to determine the effects of the technology on health outcome.

The evidence for LLLT in individuals with chronic wounds includes RCTs and systematic reviews. Relevant outcomes are symptoms, change in disease status, and treatment-related morbidity. The few existing RCTs tend to have small sample sizes and risk of bias. The evidence is insufficient to determine the effects of the technology on health outcome.

References

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Bülow PM, Jensen H, Danneskiold-Samsøe B. Low power Ga-Al-As laser treatment of painful osteoarthritis of the knee. A double-blind placebo-controlled study. Scand J Rehabil Med. 1994;26(3):155-159.

Caldieraro MA, Cassano P. Transcranial and systemic photobiomodulation for major depressive disorder: A systemic review of efficacy, tolerability and biological mechanisms. J Affect Disord. 2019;243:262-273.

Calis HT, Berberoglu N, Calis M. Are ultrasound, laser and exercise superior to each other in the treatment of subacromial impingement syndrome? A randomized clinical trial. Eur J Phys Rehabil Med. 2011;47(3):375-380.

Carcia CR, Martin RL, Houck J, et al. Achilles pain, stiffness, and muscle power deficits: achilles tendinitis. J Orthop Sports Phys Ther. 2010;40(9):A1-26.

Carrasco TG, Guerisoli LD, Guerisoli DM, et al. Evaluation of low intensity laser therapy in myofascial pain syndrome. Cranio. 2009;27(4):243-247.

 

Carrasco TG, Mazzetto MO, Mazzetto RG, et al. Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. Cranio. 2008;26(4):274-281.

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Chamani G, Zarei MR, Rad M, et al. Comparison of low-level laser therapy and standard treatment for temporomandibular disorders: An assessment of therapeutic and placebo effects. J Oral Rehabil. 2024;51(4):657-665.

Chang J, Ren Y, Wang R, et al. Transcranial low-level laser therapy for depression and alzheimer's disease. J Neuropsychiatry. 2018;8(2):477-483.

Chang WD, Lee CL, Lin HY, et al. A meta-analysis of clinical effects of low-level laser therapy on temporomandibular joint pain. J Phys Ther Sci. 2014;26(8):1297-1300.

Chang WD, Wu JH, Jiang JA, et al. Carpal tunnel syndrome treated with a diode laser: a controlled treatment of the transverse carpal ligament. Photomed Laser Surg. 2008;26(6):551-557.

 

Chellappa D, Thirupathy M. Comparative efficacy of low-Level laser and TENS in the symptomatic relief of temporomandibular joint disorders: A randomized clinical trial. Indian J Dent Res. 2020;31(1):42-47.

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Gopal Nambi S, Kamal W, George J, et al. Radiological and biochemical effects (CTX-II, MMP-3, 8, and 13) of low-level laser therapy (LLLT) in chronic osteoarthritis in Al-Kharj, Saudi Arabia. Lasers Med Sci. 2017;32(2):297-303.


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Gur A, Karakoc M, Cevik R, et al. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med. 2003;32(3):233-238.


Gworys K, Gasztych J, Puzder A, et al. Influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis. Ortop Traumatol Rehabil. 2012;14(3):269-277.


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Hegedus B, Viharos L, Gervain M, et al. The effect of low-level laser in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial. Photomed Laser Surg. 2009;27(4):577-584.


Helianthi DR, Simadibrata C, Srilestari A, et al. Pain Reduction After Laser Acupuncture Treatment in Geriatric Patients with Knee Osteoarthritis: a Randomized Controlled Trial. Acta Med Indones. 2016;48(2):114-121.


Herpich CM, Leal-Junior ECP, Politti F, et al. Intraoral photobiomodulation diminishes pain and improves functioning in women with temporomandibular disorder: a randomized, sham-controlled, double-blind clinical trial: Intraoral photobiomodulation diminishes pain in women with temporomandibular disorder. Lasers Med Sci. 2020;35(2):439-445.


Hinman RS, McCrory P, Pirotta M, et al. Acupuncture for chronic knee pain: a randomized clinical trial. JAMA. 2014;312(13):1313-1322.


Honda Y, Sakamoto J, Hamaue Y, et al. Effects of Physical-Agent Pain Relief Modalities for Fibromyalgia Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Res Manag. 2018;2018:2930632.


Hsieh RL, Lee WC. Short-term therapeutic effects of 890-nanometer light therapy for chronic low back pain: a double-blind randomized placebo-controlled study. Lasers Med Sci. 2014;29(2):671-679.

Huang Z, Chen J, Ma J, et al. Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2015;23(9):1437-1444.

Huang Z, Ma J, Chen J, et al. The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther. 2015;17:360.

Irvine J, Chong SL, Amirjani N, et al. Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome. Muscle Nerve. 2004;30(2):182-187.


Jensen H, Harreby M, Kjer J. [Infrared laser--effect in painful arthrosis of the knee?]. Ugeskr Laeger. 1987;149(46):3104-3106.


Khairnar S, Bhate K, Santhosh Kumar SN, et al. Comparative evaluation of low-level laser therapy and ultrasound heat therapy in reducing temporomandibular joint disorder pain. J Dent Anesth Pain Med. 2019;19(5):289-294.


Kheshie AR, Alayat MS, Ali MM. High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers Med Sci. 2014;29(4):1371-1376.

Kiritsi O, Tsitas K, Malliaropoulos N, et al. Ultrasonographic evaluation of plantar fasciitis after low-level laser therapy: results of a double-blind, randomized, placebo-controlled trial. Lasers Med Sci. 2010;25(2):275-281.


Klein RG, Eek BC. Low-energy laser treatment and exercise for chronic low back pain: double-blind controlled trial. Arch Phys Med Rehabil. 1990;71(1):34-37.


Koldaş Doğan Ş, Ay S, Evcik D. The effects of two different low level laser therapies in the treatment of patients with chronic low back pain: A double-blinded randomized clinical trial. J Back Musculoskelet Rehabil. 2017;30(2):235-240.


Konstantinovic L, Lazovic M, Milovanovic N, et al. Low level laser therapy in geriatric patients with low back pain. Eur J Pain Suppl (Poster Sessions). 2011;5:61. 

Konstantinovic LM, Kanjuh ZM, Milovanovic AN, et al. Acute low back pain with radiculopathy: a double-blind, randomized, placebo-controlled study. Photomed Laser Surg. 2010;28(4):553-560.


Koutenaei FR, Mosallanezhad Z, Naghikhani M, et al. The effect of low level laser therapy on pain and range of motion of patients with knee osteoarthritis. Physical Treatments - Specific Physical Therapy. 2017;7:1318.


Kuduruthullah S. Effectiveness of Low-Level Laser Therapy in the Management of the Temporomandibular Joint Disorders: A Placebo-Controlled Trial. World Journal of Dentistry, n.d. doi:10.5005/JP-JOURNALS-10015-1555.


Kulekcioglu S, Sivrioglu K, Ozcan O, et al. Effectiveness of low-level laser therapy in temporomandibular disorder. Scand J Rheumatol. 2003;32(2):114-118.


Lalla RV, Bowen J, Barasch A, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120(10):1453-1461.


Lassemi E, Jafari SM, Motamedi MHK, et al. Low-level laser therapy in the management of temporomandibular joint disorder. J Oral Laser Appl. 2008;8:8386.


Lauxen AC, Machado DR, Pereira DS, et al. Photobiomodulation in carpal tunnel syndrome with pain, strength, and functionality analysis: a systematic review and meta-analysis. Lasers Med Sci. 2025;40(1):12.


Li S, Wang C, Wang B, et al. Efficacy of low-level light therapy for treatment of diabetic foot ulcer: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. 2018;143:215-224.


Li ZJ, Wang Y, Zhang HF, et al. Effectiveness of low-level laser on carpal tunnel syndrome: A meta-analysis of previously reported randomized trials. Medicine (Baltimore). 2016;95(31):e4424.


Lin ML, Wu HC, Hsieh YH, et al. Evaluation of the effect of laser acupuncture and cupping with ryodoraku and visual analog scale on low back pain. Evid Based Complement Alternat Med. 2012;2012:521612.

 

Lourinho I, Sousa T, Jardim R, et al. Effects of low-level laser therapy in adults with rheumatoid arthritis: A systematic review and meta-analysis of controlled trials. PLoS One. 2023;18(9):e0291345.


Lucas C, van Gemert MJ, de Haan RJ. Efficacy of low-level laser therapy in the management of stage III decubitus ulcers: a prospective, observer-blinded multicentre randomised clinical trial. Lasers Med Sci. 2003;18(2):72-77.


Machado RS, Viana S, Sbruzzi G. Low-level laser therapy in the treatment of pressure ulcers: systematic review. Lasers Med Sci. 2017;32(4):937-944.

 

Macias DM, Coughlin MJ, Zang K, et al. Low-Level Laser Therapy at 635 nm for Treatment of Chronic Plantar Fasciitis: A Placebo-Controlled, Randomized Study. J Foot Ankle Surg. 2015;54(5):768-772.


Madani A, Ahrari F, Fallahrastegar A, et al. A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers Med Sci. 2020;35(1):181-192.


Magri LV, Bataglion C, Leite-Panissi CRA. Follow-up results of a randomized clinical trial for low-level laser therapy in painful TMD of muscular origins. Cranio. 2021;39(6):502-509.

Mandel A, Hamblin MR. A renaissance in low-level laser (light) therapy-LLLT. Photonics and Lasers In Medicine 1. no. 4 (January 1, 2012), pp. 231-243.


Maracci LM, Stasiak G, de Oliveira Chami V, et al. Treatment of myofascial pain with a rapid laser therapy protocol compared to occlusal splint: A double-blind, randomized clinical trial. Cranio. 2022;40(5):433-439.

Marini I, Gatto MR, Bonetti GA. Effects of superpulsed low-level laser therapy on temporomandibular joint pain. Clin J Pain. 2010;26(7):611-616.

 

Maŕin-Conde F, Castellanos-Cosano L, Pachón-Ibanez J, et al. Photobiomodulation with low-level laser therapy reduces oral mucositis caused by head and neck radio-chemotherapy; prospective randomized controlled trial. Int J Oral Maxillofac Surg. 2019. 48(7) 917-923.

 

Martimbianco ALC, Ferreira RES, Latorraca COC, et al. Photobiomodulation with low-level laser therapy for treating achilles tendinopathy; a systematic review and meta-analysis. Clin Rehabil. 2020;34(6)713-722.


Martin RL, Chimenti R, Cuddeford T, et al. Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018. J Orthop Sports Phys Ther. 2018;48(5):A1-A38.


Marovino T, Majewski M. Pain therapy options for the home. A patient-based outcome review of at-home pain management devices, including the Willow Curve, Quell, and VibraCool. Practical Pain Management. 2019; 19(1): 56-59.

Matsutani LA, Marques AP, Ferreira EA, et al. Effectiveness of muscle stretching exercises with and without laser therapy at tender points for patients with fibromyalgia. Clin Exp Rheumatol. 2007;25(3):410-415.

 

Mazzetto MO, Carrasco TG, Bidinelo EF, et al. Low intensity laser application in temporomandibular disorders: a phase I double-blind study. Cranio. 2007;25(3):186-92.

Meireles SM, Jones A, Jennings F, et al. Assessment of the effectiveness of low-level laser therapy on the hands of patients with rheumatoid arthritis: a randomized double-blind controlled trial. Clin Rheumatol. 2010;29(5):501-509.


Mohammed N, Allam H, Elghoroury E, et al. Evaluation of serum beta-endorphin and substance P in knee osteoarthritis patients treated by laser acupuncture. J Complement Integr Med. 2018;15(2).


Monteiro L, Ferreira R, Resende T, et al. Effectiveness of Photobiomodulation in Temporomandibular Disorder-Related Pain Using a 635 nm Diode Laser: A Randomized, Blinded, and Placebo-Controlled Clinical Trial. Photobiomodul Photomed Laser Surg. 2020;38(5):280-288.

 

Nadershah M, Abdel-Alim HM, Bayoumi AM, et al. Photobiomodulation Therapy for Myofascial Pain in Temporomandibular Joint Dysfunction: A Double-Blinded Randomized Clinical Trial. J Maxillofac Oral Surg. 2020;19(1):93-97.

 

Nambi G, Kamal W, Es S, et al. Spinal manipulation plus laser therapy versus laser therapy alone in the treatment of chronic non-specific low back pain: a randomized controlled study. Eur J Phys Rehabil Med. 2018;54(6):880-889.

 

Naterstad IF, Joensen J, Bjordal JM, et al. Efficacy of low-level laser therapy in patients with lower extremity tendinopathy or plantar fasciitis: systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2022;12(9):e059479.

National Comprehensive Cancer Network (NCCN). Head and Neck Cancers. V4.2024. [NCCN Web site]. 05/01/2024. Available at: http://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf. Accessed August 20, 2024.

 

National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management [NG59]. Published 2016. Updated 2020. Available at: https://www.nice.org.uk/guidance/ng59. Accessed September 24, 2025.

 

Navarro-Ledesma S, Carroll J, Burton P, et al. Short-Term Effects of Whole-Body Photobiomodulation on Pain, Quality of Life and Psychological Factors in a Population Suffering from Fibromyalgia: A Triple-Blinded Randomised Clinical Trial. Pain Ther. 2023;12(1):225-239.

 

Navarro-Ledesma S, Carroll J, González-Muñoz A, et al. Changes in Circadian Variations in Blood Pressure, Pain Pressure Threshold and the Elasticity of Tissue after a Whole-Body Photobiomodulation Treatment in Patients with Fibromyalgia: A Tripled-Blinded Randomized Clinical Trial. Biomedicines. 2022;10(11).

 

Nivbrant B, Friberg S. [Laser treatment of knee joint arthrosis seems to be effective but scientific evidence is lacking]. Lakartidningen. 1992;89(11):859-861.

 

North American Spine Society. Evidence-based clinical guidelines for multidisciplinary spine care. 2020. Available at:  https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf. Accessed September 24, 2025.

 

Nussbaum EL, Biemann I, Mustard B. Comparison of ultrasound/ultraviolet-C and laser for treatment of pressure ulcers in patients with spinal cord injury. Phys Ther. 1994;74(9):812-23; discussion 824-825.

Oberoi S, Zamperlini-Netto G, Beyene J, et al. Effect of prophylactic low level laser therapy on oral mucositis: a systematic review and meta-analysis. PLoS One. 2014;9(9):e107418.

 

Okamoto H. Therapeutic effect of semiconductor laser irradiation on low-back pain. The Journal of Balneology, Climatology and Physical Medicine. 1989;52:131-145.

Omar MT, Shaheen AA, Zafar H. A systematic review of the effect of low-level laser therapy in the management of breast cancer-related lymphedema. Support Care Cancer. 2012;20:2977-2984.

Omar MTA, Ebid AA, El Morsy AM. Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study. J Surg Res. 2011;165(1):82-90.


Ordahan B, Karahan AY. Role of low-level laser therapy added to facial expression exercises in patients with idiopathic facial (Bell's) palsy. Lasers Med Sci. 2017;32(4):931-936.


Oton-Leite AF, Silva GB, Morais MO, et al. Effect of low-level laser therapy on chemoradiotherapy-induced oral mucositis and salivary inflammatory mediators in head and neck cancer patients. Lasers Surg Med. 2015;47(4):296-305.

 

Öz S, Gökçen-Röhlig B, Saruhanoglu A, et al. Management of myofascial pain: low-level laser therapy versus occlusal splints. J Craniofac Surg. 2010;21(6):1722-1728.

Page MJ, Green S, Kramer S, et al. Electrotherapy modalities for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev. 2014;10:CD011324.


Panhoca VH, Lizarelli Rde F, Nunez SC, et al. Comparative clinical study of light analgesic effect on temporomandibular disorder (TMD) using red and infrared led therapy. Lasers Med Sci. 2015;30(2):815-822.


Peimani A, Keshavarz S, Fathollahi MS. Comparison of Low-Level Laser Therapy and Drug Therapy in Patients with Temporomandibular Disorders: A Randomized Clinical Trial. J Oral Health Dent. 2020;38:240247.

 

Peng J, Shi Y, Wang J, et al. Low level laser therapy in the prevention of oral mucositis: a systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;130(4):387-397.


Pereira TS, Flecha OD, Guimarães RC, et al. Efficacy of red and infrared lasers in treatment of temporomandibular disorders--a double-blind, randomized, parallel clinical trial. Cranio. 2014;32(1):51-56.

Petrucci A, Sgolastra F, Gatto R, et al. Effectiveness of low-level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. J Orofac Pain. 2011;25(4):298-307.


Qaseem A, McLean RM, O'Gurek D, et al. Nonpharmacologic and Pharmacologic Management of Acute Pain From Non-Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians. Ann Intern Med. 2020;173(9):739-748.


Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.


Rankin IA, Sargeant H, Rehman H, et al. Low-level laser therapy for carpal tunnel syndrome. Cochrane Database Syst Rev. 2017 Aug 22;8(8):CD012765. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012765/full. Accessed September 24, 2025.


Rayegani SM, Bahrami MH, Elyaspour D, et al. Therapeutic effects of low level laser therapy (LLLT) in knee osteoarthritis, compared to therapeutic ultrasound. J Lasers Med Sci. 2012;3:7174.


Reyad FA, Elsayed NM, El Chazli Y. Photobiomodulation for chemotherapy-induced oral mucositis in leukemic children: A randomized controlled clinical trial. Oral Dis. 2023;29(5):2239-2247.


Rezazadeh F, Hajian K, Shahidi S, et al. Comparison of the Effects of Transcutaneous Electrical Nerve Stimulation and Low-Level Laser Therapy on Drug-Resistant Temporomandibular Disorders. J Dent (Shiraz). 2017;18(3):187-192.


Rodrigues CA, Melchior MO, Valencise Magri L, et al. Can the severity of orofacial myofunctional conditions interfere with the response of analgesia promoted by active or placebo low-level laser therapy? Cranio. 2020;38(4):240-247.


Rohlig BG, Kipirdi S, Meric U, et al. Masticatory muscle pain and low-level laser therapy: A double-blind and placebo-controlled study. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2011;57:3137.

Ruaro JA, Frez AR, Ruaro MB, et al. Low-level laser therapy to treat fibromyalgia. Lasers Med Sci. 2014;29(6):1815-1819.


Ruth M, Weber M, Zenz M. Laser acupuncture for chronic back pain. A double-blind clinical study. Schmerz. 2010;24(5):485-493.


Salehpour F, Rasta SH. The potential of transcranial photobiomodulation therapy for treatment of major depressive disorder. Rev Neurosci. 2017;28(4):441-453.

Samson D, Lefevre F, Aronson N. Wound-healing technologies: low-level laser and vacuum-assisted closure. Evid Rep Technol Assess (Summ). 2004(111):1-6.


Sancakli E, Gökçen-Röhlıg B, Balık A, et al. Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC Oral Health. 2015;15(1):131.


Santos Tde S, Piva MR, Ribeiro MH, et al. Lasertherapy efficacy in temporomandibular disorders: control study. Braz J Otorhinolaryngol. 2010;76(3):294-299.


Sattayut S, Bradley P. A study of the influence of low intensity laser therapy on painful temporomandibular disorder patients. Laser Ther. 2012;21(3):183-192.

Schubert MM, Eduardo FP, Guthrie KA, et al. A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation. Support Care Cancer. 2007;15(10):1145-1154.


Seifi M, Ebadifar A, Kabiri S, et al. Comparative effectiveness of Low Level Laser therapy and Transcutaneous Electric Nerve Stimulation on Temporomandibular Joint Disorders. J Lasers Med Sci. 2017;8(Suppl 1):S27-S31.


Shen B, Zhou Y, Wu D, et al. Efficacy of photobiomodulation therapy in the management of oral mucositis in patients with head and neck cancer: A systematic review and meta-analysis of randomized controlled trials. Head Neck. 2024;46(4):936-950.


Shin JY, Ku B, Kim JU, et al. Short-Term Effect of Laser Acupuncture on Lower Back Pain: A Randomized, Placebo-Controlled, Double-Blind Trial. Evid Based Complement Alternat Med. 2015;2015:808425.


Shirani AM, Gutknecht N, Taghizadeh M, et al. Low-level laser therapy and myofascial pain dysfunction syndrome: a randomized controlled clinical trial. Lasers Med Sci. 2009;24(5):715-720.


Shobha R, Narayanan VS, Jagadish Pai BS, et al. Low-level laser therapy: A novel therapeutic approach to temporomandibular disorder - A randomized, double-blinded, placebo-controlled trial. Indian J Dent Res. 2017;28(4):380-387.


Shousha T, Alayat M, Moustafa I. Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with temporomandibular dysfunction: A randomized-controlled study. PLoS One. 2021;16(10):e0258063.

 

Skelly AC, Chou R, Dettori JR, et al. Noninvasive nonpharmacological treatment for chronic pain: A systematic review. Comparative Effectiveness Review No. 209. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I). AHRQ Publication No 18-EHC013-EF.

 

Smoot B, Chiavola-Larson L, Lee J, et al. Effect of low-level laser therapy on pain and swelling in women with breast cancer-related lymphedema: a systematic review and meta-analysis. J Cancer Surviv. 2015;9(2):287-304.


Sobral APT, Godoy CLH, Fernandes KPS, et al. Photomodulation in the treatment of chronic pain in patients with temporomandibular disorder: protocol for cost-effectiveness analysis. BMJ Open. 2018;8(5):e018326.


Soriano F, Rios R. Gallium arsenide laser treatment of chronic low back pain: a prospective, randomized and double blind study. Laser Ther. 1998;10:17580. 


Stausholm MB, Naterstad IF, Joensen J, et al. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open. 2019;9(10):e031142.

Stergioulas A. Low-power laser treatment in patients with frozen shoulder: preliminary results. Photomed Laser Surg. 2008;26(2):99-105.

Stergioulas A, Stergioula M, Aarskog R, et al. Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy. Am J Sports Med. 2008;36(5):881-887.


Sung L, Robinson P, Treister N, et al. Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation. BMJ Support Palliat Care. 2017;7(1):7-16.


Taly AB, Sivaraman Nair KP, Murali T, et al. Efficacy of multiwavelength light therapy in the treatment of pressure ulcers in subjects with disorders of the spinal cord: A randomized double-blind controlled trial. Arch Phys Med Rehabil. 2004;85(10):1657-1661.


Tantawy SA, Abdelbasset WK, Kamel DM, et al. Laser photobiomodulation is more effective than ultrasound therapy in patients with chronic nonspecific low back pain: a comparative study. Lasers Med Sci. 2019;34(4):793-800.


Taradaj J, Halski T, Kucharzewski M, et al. Effect of laser irradiation at different wavelengths (940, 808, and 658 nm) on pressure ulcer healing: results from a clinical study. Evid Based Complement Alternat Med. 2013;2013:960240.


Tascioglu F, Armagan O, Tabak Y, et al. Low power laser treatment in patients with knee osteoarthritis. Swiss Med Wkly. 2004;134(17-18):254-258.

Tascioglu F, Degirmenci NA, Ozkan S, et al. Low-level laser in the treatment of carpal tunnel syndrome: clinical, electrophysiological, and ultrasonographical evaluation. Rheumatol Int. 2012;32(2):409-415.

Tumilty S, McDonough S, Hurley DA, et al. Clinical effectiveness of low-level laser therapy as an adjunct to eccentric exercise for the treatment of Achilles' tendinopathy: a randomized controlled trial. Arch Phys Med Rehabil. 2012;93(5):733-739.


Uemoto L, Garcia MA, Gouvêa CV, et al. Laser therapy and needling in myofascial trigger point deactivation. J Oral Sci. 2013;55(2):175-181.


Umegaki S. Effectiveness of low-power laser therapy on low-back pain: double blind comparative study to evaluate the analgesic effect of low-power laser therapy. Kiso to Rinsho (The Clinical Report). 1989;23:283946.


Vallone F, Benedicenti S, Sorrenti E, et al. Effect of diode laser in the treatment of patients with nonspecific chronic low back pain: a randomized controlled trial. Photomed Laser Surg. 2014;32(9):490-494.

 

Venancio Rde A, Camparis CM, Lizarelli Rde F. Low intensity laser therapy in the treatment of temporomandibular disorders: a double-blind study. J Oral Rehabil. 2005;32(11):800-807.

Venezian GC, da Silva MA, Mazzetto RG, et al. Low level laser effects on pain to palpation and electromyographic activity in TMD patients: a double-blind, randomized, placebo-controlled study. Cranio. 2010;28(2):84-91.


Wang W, Jiang W, Tang C, et al. Clinical efficacy of low-level laser therapy in plantar fasciitis: A systematic review and meta-analysis. Medicine (Baltimore). 2019;98(3):e14088.


Wang X, Yang Z, Zhang W, et al. [Efficacy evaluation of low-level laser therapy on temporomandibular disorder]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2011;29(4):393-395, 399.

Wu D, Zhao YL, Sun JY, et al. A Nonrandomized Trial of the Effects of Near-Infrared Photobiomodulation Therapy on Bell's Palsy with a Duration of Greater Than 8 Weeks. Photobiomodul Photomed Laser Surg. 2023;41(9):490-500. 


Xu Z, Guo X, Yang Y, et al. Low-level laser irradiation improves depression-like behaviors in mice. Mol Neurobiol. 2017;54(6):4551-4559.


Yamaner FE, Celakil T, Gökcen Roehlig B. Comparison of the efficiency of two alternative therapies for the management of temporomandibular disorders. Cranio. 2022;40(3):189-198.

Yeldan I, Cetin E, Ozdincler AR. The effectiveness of low-level laser therapy on shoulder function in subacromial impingement syndrome. Disabil Rehabil. 2009;31(11):935-940.

Yousefi-Nooraie R, Schonstein E, Heidari K, et al. Low level laser therapy for nonspecific low-back pain. Cochrane Database Syst Rev. 2008(2):CD005107.


Youssef EF, Muaidi QI, Shanb AA. Effect of Laser Therapy on Chronic Osteoarthritis of the Knee in Older Subjects. J Lasers Med Sci. 2016;7(2):112-119.

 

Zhang Y, Qian Y, Huo K, et al. Efficacy of laser therapy for temporomandibular disorders: A systematic review and meta-analysis. Complement Ther Med. 2023;74:102945.

Coding

CPT Procedure Code Number(s)
MEDICALLY NECESSARY

1011T

EXPERIMENTAL/INVESTIGATIONAL

97037, 0552T
ICD - 10 Procedure Code Number(s)
N/A
ICD - 10 Diagnosis Code Number(s)
LOW-LEVEL LASER THERAPY (S8948, 1011T) IS MEDICALLY NECESSARY IN INDIVIDUALS WHO ARE UNDERGOING CANCER TREATMENT

Z51.0 Encounter for antineoplastic radiation therapy

Z51.11 Encounter for antineoplastic chemotherapy

Z92.21 Personal history of antineoplastic chemotherapy

Z92.3 Personal history of irradiation

Z94.84 Stem cells transplant status
HCPCS Level II Code Number(s)
S8948 Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes
Revenue Code Number(s)
N/A


Coding and Billing Requirements

Policy History

Revisions From 07.00.14i:
​​​01/01/2026
​This policy has been identified for the CPT code update, effective 01/01/2026.
​​
​The following CPT code has been added to the policy (Medically Necessary): 1011T.

Revisions From 07.00.14h:
​​10/29/2025
​This policy has been reviewed and reissued to communicate the Company’s             
continuing position on low-level laser therapy (LLLT).
​09/04/2024
​This policy has been reviewed and reissued to communicate the Company’s             
continuing position on Low-level Laser Therapy (LLLT).
01​/02/2024
This policy has been identified for the CPT code update, effective 01/02/2024.

The following CPT code has been added to the policy (Experimental/Investigational):
97037​​

Revisions From 07.00.14g:​​
​02/08/2023

​The policy has been reviewed and reissued to communicate the Company’s             
continuing position on Low-level Laser Therapy (LLLT).
​05/18/2022

​The policy has been reviewed and reissued to communicate the Company’s continuing position on Low-level Laser Therapy (LLLT).
06/02/2021The policy has been reviewed and reissued to communicate the Company’s continuing position on Low-level Laser Therapy (LLLT).
​04/08/2020
The policy has been reviewed and reissued to communicate the Company’s continuing position on Low-level Laser Therapy (LLLT)​.
09/30/2019This version of the policy will become effective 09/30/2019.

The policy has been updated to communicate the Company's experimental/investigational position for low-level laser therapy with dynamic photonic and thermokinetic energy.

The following CPT code has been added to the policy: 0552T.

The following ICD-10 diagnosis codes have been added to the policy:
Z51.0, Z51.11, Z92.21, Z92.3, Z94.84.

Revisions From 07.00.14f:
03/13/2019The policy has been reviewed and reissued to communicate the Company’s continuing position on Low-level Laser Therapy (LLLT).
​03/14/2018
The policy has been reviewed and reissued to communicate the Company’s continuing position on Low-level Laser Therapy (LLLT)​.

Effective 10/05/2017 this policy has been updated to the new policy template format.
1/1/2026
1/2/2026
07.00.14
Medical Policy Bulletin
Commercial
No
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