BlueCross BlueShield of Tennessee Medical Policy Manual

Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit/Hyperactivity Disorder (ADHD)


Individuals with attention-deficit/hyperactivity disorder (ADHD) may have alterations in their brain wave patterns that can be measured by quantitative electroencephalography. A commercially available system, the Neuropsychiatric EEG-based ADHD Assessment Aid (NEBA®) measures the resting theta/beta ratio of the electroencephalogram. This technology is being evaluated to aid in the diagnosis of adolescents and children for whom there is a clinical suspicion of ADHD. The system is not intended to evaluate individuals for whom the clinician’s diagnosis of ADHD is negative, and the system does not generate an interpretive report in this situation. It is also proposed that the clinician’s diagnostic impression plus the results generated by the NEBA system may reduce the potential for over diagnosis of ADHD and thereby reduce the risks of administering unnecessary pharmacologic therapy in the intended-use population.




Published peer-reviewed studies that evaluate the accuracy of commercially available devices (e.g., NEBA®) in the diagnosis of ADHD are scant. The effect/impact of this technology on health outcomes is not known.


American Academy of Neurology. (2016, November). Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis. Retrieved April 23, 2018 from

BlueCross BlueShield Association. Evidence Positioning System. (11:2020). Quantitative electroencephalography as a diagnostic aid for attention-deficit/hyperactivity disorder (3.01.03). Retrieved January 8, 2021 from (7 articles and/or guidelines reviewed)

Kim, J. W., Lee, J., Kim, H. J., Lee Y. S., & Min, K. J. (2015). Relationship between theta-phase gamma-amplitude coupling and attention-deficit/hyperactivity behavior in children. Neuroscience Letters, 590, 12-17. Abstract retrieved July 24, 2015 from PubMed database.

Kim, J., Lee, Y., Han, D., Min, K., Kim, D., & Lee, C. (2015). The utility of quantitative electroencephalography and integrated visual and auditory continuous performance test as auxiliary tools for the Attention Deficit Hyperactivity Disorder diagnosis. Clinical Neurophysiology, 126 (3), 532-40. Abstract retrieved April 20, 2017 from PubMed database.

Snyder, S. M., Rugino, T. A., Hornig, M., & Stein, M. A. (2015). Integration of an EEG biomarker with a clinician’s ADHD evaluation. Brain and Behavior, 5 (4). (Level 3 evidence)

U.S. Food and Drug Administration. (2013, July). Center for Devices and Radiological Health. De novo classification request for Neuropsychiatric EEG-Based Assessment Aid for ADHD (NEBA) System. Retrieved November 18, 2013 from




Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

This document has been classified as public information.