Medical policy: Skin Contact Monochromatic Infrared Energy for the Treatment of Cutaneous Ulcers, Diabetic Neuropathy, and Other Miscellaneous Musculoskeletal Conditions

Policy number: MP 1.094

Effective date: 11/1/2026

Policy

Skin contact monochromatic infrared energy is considered investigational as a technique to treat cutaneous ulcers, diabetic neuropathy, and musculoskeletal conditions, including but not limited to temporomandibular disorders, tendonitis, capsulitis, and myofascial pain. There is insufficient evidence to support a general conclusion concerning the health outcomes or benefits associated with this procedure.

Cross-reference

• MP 1.097 Low Level Laser Therapy

Product variations

This policy is only applicable to certain programs and products administered by Capital Blue Cross and subject to benefit variations. Please see additional information below.

FEP PPO - Refer to Section VI of the FEP Medical Policy Manual. The FEP Medical Policy Manual can be found at: FEP Medical Policy Manual.

Description/Background

Monochromatic infrared energy treatment (MIRE™) is a therapy that uses infrared light therapy through contact with the skin for potential use in multiple conditions including cutaneous ulcers, diabetic neuropathy, and musculoskeletal and soft tissue injuries.

Monochromatic infrared energy (MIRE) refers to light at a wavelength of 880 nm. MIRE can be delivered through pads containing an array of 60 superluminous infrared diodes emitting pulsed near-infrared irradiation. The pads can be placed on the skin, and the infrared energy is delivered in a homogeneous manner in a session lasting from 30 to 45 minutes.

MIRE devices have been investigated as a treatment of multiple conditions including cutaneous ulcers, diabetic neuropathy, Bell’s palsy, musculoskeletal and soft tissue injuries, including temporomandibular disorders, tendonitis, capsulitis, and myofascial pain. MIRE devices are also being developed for the treatment of baldness and snoring. The proposed mechanism of action is not known, although some sort of photobiostimulation has been proposed, as well as increased circulation related to an increase in plasma of the potent vasodilator nitric oxide.

Rationale

Summary of evidence

The available literature regarding skin contact monochromatic infrared energy (MIRE) as a technique to treat various cutaneous conditions consists of small, controlled trials and observational studies. MIRE has also been investigated for knee osteoarthritis. The current evidence from the studies with the strongest methodology, i.e., sham-controlled trials with a between-group design, shows no improvement in outcomes for patients treated with MIRE. This evidence does not support the efficacy of this technology. Well designed, prospective, randomized controlled trials with larger subject numbers are needed to determine with certainty whether MIRE is an effective treatment for cutaneous conditions. Similarly, MIRE therapy has been studied as a treatment for Bell’s palsy. Results of case studies did not demonstrate any effectiveness as this therapy in managing Bell’s palsy. As a result, this technology is considered investigational.

Definitions

Photobiostimulation refers to a process associated with low-level laser therapy, which activates enzymatic processes in the cells, which increase cellular metabolism.

Disclaimer

Capital Blue Cross’ medical policies are used to determine coverage for specific medical technologies, procedures, equipment, and services. These medical policies do not constitute medical advice and are subject to change as permitted by law or applicable clinical evidence from independent treatment guidelines. Treating providers are solely responsible for medical advice and treatment of members. These polices are not a guarantee of coverage or payment. Payment of claims is subject to a determination regarding the member’s benefit program and eligibility on the date of service, and a determination that the services are medically necessary and appropriate. Final processing of a claim is based upon the terms of contract that applies to the members’ benefit program, including benefit limitations and exclusions. If a provider or a member has a question concerning this medical policy, please contact Capital Blue Cross’ Provider Services or Member Services.

Coding information

Note: This list of codes may not be all-inclusive, and codes are subject to change at any time. The identification of a code in this section does not denote coverage as coverage is determined by the terms of member benefit information. In addition, not all covered services are eligible for separate reimbursement.

Investigational; therefore, not covered

References

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2. Ites KI, Anderson EJ, Cahill ML, et al. Balance interventions for diabetic peripheral neuropathy: a systematic review. J Geriatr Phys Ther. 2011;34(3):109-116.
3. Lavery LA, Murdoch DP, Williams J, et al. Does anodyne light therapy improve peripheral neuropathy in diabetes? A double-blind, sham-controlled, randomized trial to evaluate monochromatic infrared photoenergy. Diabetes Care. 2008;31(2):316-321.
4. Clifft JK, Kasser RJ, Newton TS, et al. The effect of monochromatic infrared energy on sensation in patients with diabetic peripheral neuropathy: a double-blind, placebo-controlled study. Diabetes Care. 2005;28(12):2896-2900.
5. Nawfar SA, Yacob NB. Effects of monochromatic infrared energy therapy on diabetic feet with peripheral sensory neuropathy: a randomised controlled trial. Singapore Med J. Sep 2011;52(9):669-672. PMID 21947144
6. Franzen-Korzendorfer H, Blackinton M, Rone-Adams S, et al. The effect of monochromatic infrared energy on transcutaneous oxygen measurements and protective sensation: results of a controlled, double-blind, randomized clinical study. Ostomy Wound Manage. 2008;54(6):16-31.
7. Leonard DR, Farooqi MH, Myers S. Restoration of sensation, reduced pain and improved balance in subjects with diabetic peripheral neuropathy: a double-blind, randomized, placebo-controlled study with monochromatic near-infrared treatment. Diabetes Care. 2004;27(1):168-172.
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9. Powell MW, Carnegie DE, Burke TJ. Reversal of diabetic peripheral neuropathy and new wound incidence: the role of MIRE. Adv Skin Wound Care. 2004;17(6):295-300.
10. Prendergast JJ, Miranda G, Sanchez M. Improvement of sensory impairment in patients with peripheral neuropathy. Endocr Pract. 2004;10(1):24-30.
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12. Kochman AB, Carnegie DH, Burke TJ. Symptomatic reversal of peripheral neuropathy in patients with diabetes. J Am Podiatr Med Assoc. 2002;92(3):125-130.
13. Horwitz LR, Burke TJ, Carnegie D. Augmentation of wound healing using monochromatic infrared energy. Exploration of a new technology for wound management. Adv Wound Care. 1999; 12(1):35-40.
14. Hsieh RL, Lo MT, Lee WC, et al. Therapeutic effects of short-term monochromatic infrared energy therapy on patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study. J Orthop Sports Phys Ther. 2012; 42(11):947-956. PMID 22960644
15. Association for the Advancement of Wound Care. Association for the Advancement of Wound Care Guideline of Pressure Ulcer Guidelines
16. UpToDate Online Journal [serial online]. Feldman, E.: Management of diabetic neuropathy UpToDate; updated June 18, 2026. Literature review through Jun 2026.
17. Robinson CC, Klahr PDS, Stein C, Falavigna M, Sbruzzi G, Della MéaPlentz R. Effects of monochromatic infrared phototherapy in patients with diabetic peripheral neuropathy: a systematic review and meta-analysis of randomized controlled trials. Braz J Phys Ther. 2017 Jul-Aug; 21(4): 233–243. PMID: 28571697
18. UpToDate Online Journal [serial online]. Kelly MD, K.: Laser and light therapy for cutaneous and vascular lesions UpToDate; updated Jun 19, 2026. Literature review current through Jun 2026.
19. Ng, S. Y., & Chu, M. H. (2014). Treatment of Bell's Palsy Using Monochromatic Infrared Energy: A Report of 2 Cases. Journal of chiropractic medicine, 13(2), 96–103. PMID 2565117
20. He Y, Yip SL, Cheung KK, Huang L, Wang S, Cheing GL. The effect of monochromatic infrared energy on diabetic wound healing. Int Wound J. 2013;10(6):645-652. doi:10.1111/j.1742-481X.2012.01039.x PMID: 22776615
21. Rastogi A, Uppula P, Saikia U, Bhansali A. Effect of Monochromatic Infrared Energy on Quality of Life and Intraepidermal Nerve Fiber Density in Painful Diabetic Neuropathy: A Randomized, Sham Control Study. Neurol India. 2021;69(5):1331-1337. doi:10.4103/0028-3886.329614 PMID: 34747807
22. Rodica Pop-Busui, Andrew J.M. Boulton, Eva L. Feldman, Vera Bril, Roy Freeman, Rayaz A. Malik, Jay M. Sosenko, Dan Ziegler; Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 1 January 2017; 40 (1): 136–154. PMID: 27999003
23. Sousa DFM, Gonçalves MLL, Politti F, et al. Photobiomodulation with simultaneous use of red and infrared light emitting diodes in the treatment of temporomandibular disorder: study protocol for a randomized, controlled and double-blind clinical trial. Medicine (Baltimore). 2019;98(6):e14391 PIMD: 30732181