Despite FDA approval, evidence of persistent effectiveness 2 years after treatment, and 5 years of safety data in a well-defined patient population, difficulty with securing insurance coverage for patients needing BT represents a significant source of frustration for patients. Physicians frequently struggle with both private and governmental insurers to obtain approval for BT, despite evidence that the procedure yields clinical benefits. When BT was first introduced as the first procedure-based treatment of refractory asthma, Medicare continued to struggle with the designation of “reasonable and necessary” and no commercial coverage policies were established. In fact, in 2007, 3 years prior to FDA approval, multiple private insurers had already posted investigational/experimental noncoverage policies for BT. Furthermore, within 1 year after FDA approval, most other private payers had adopted similar noncoverage policies. Multiple commercial payers have continued to invoke a need for further data collection, technology assessments, and specialty society statements supporting the safety and efficacy of BT before they are willing to institute coverage. Along these lines, BT was listed originally with a temporary set of Current Procedural Terminology (CPT) codes (0276T and 0277T) as an emerging technology, service, or procedure (category 3). The principal purpose of category 3 codes is to allow for data collection and for tracking of new procedures, often in an effort to establish universal application and to provide documentation in an effort to gain FDA approval. Conversely, category 1 CPT codes represent procedures that are consistent with contemporary medical practice and are recognized by all public and private health insurance payers in the United States. Criteria to gain category 1 status include FDA approval, nationwide performance by health-care professionals, and proof of the clinical efficacy procedure,14 all current characteristics of BT.