The path to payment for virtual reality companies working in health care just became slightly smoother. AppliedVR, a company targeting chronic pain, has become the first digital therapeutic to find an easy way to secure reimbursement from the Centers for Medicare and Medicaid Services.
CMS granted AppliedVR a unique code for its flagship product, RelieVRx, and placed it in an existing benefit category: durable medical equipment. The device, which consists of a headset and software guiding patients in pain management exercises, received Food and Drug Administration authorization to treat chronic lower back pain in 2021. Starting in April, providers will be able to bill for AppliedVR’s device as durable medical equipment.
Securing approval from the FDA is one hurdle. But convincing insurers to pay for a new therapy, especially for novel digital health tools or devices, is another odyssey altogether. Digital therapeutics, which are loosely defined as clinically-tested therapies enabled by software, don’t fit neatly into a payment box. Companies like Pear Therapeutics, which offers cognitive behavioral therapy within smartphone apps, have struggled to earn coverage from commercial payers. Advocates of the technology hope CMS might lead the charge — earlier this month, several senators reintroduced a bill that would require CMS to provide a coverage category for this software.
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