The U.S. Centers for Medicare & Medicaid Services (CMS) has created a new code for virtual reality (VR) cognitive behavioral therapy (CBT) devices, including pre-programmed therapy software.
The new Level II Healthcare Common Procedure Coding System (HCPCS) code could make it easier for Medicare payers to cover virtual reality in the future. While CMS has not established a payment determination for code, the agency did note that it will be addressed at “subsequent HCPCS” public meetings.
The code, which categorizes VR as durable medical equipment, was made in response to an application from digital health company AppliedVR to cover its RelieVRx program. In 2022, AppliedVR landed an FDA De Novo clearance for its EaseVRx system, which was designed to treat chronic lower back pain through cognitive behavioral health therapy and other mindfulness techniques.
“We envision immersive therapeutics as a future alternative to a lifetime of pills or costly surgeries,” Matthew Stoudt, co-founder and CEO of AppliedVR, said in a statement.” Enabling broad coverage for the RelieVRx program will deliver a powerful, yet affordable and scalable digital solution for millions of people.”
There are a number of VR products on the market targeted at treating patients with behavioral health conditions. But reimbursement for these products have posed a major challenge.
While this may be a win for the industry, some industry insiders note this shouldn’t be the industry’s only path to profitability.
“Current Digital Therapeutics (DTx) models are still focusing on fee for service (FFS) DTx, which hasn’t been successful in the past,” Aaron Gani, CEO and founder of BehaVR, wrote to Behavioral Health Business in an email. “Payers don’t want to just pay for new technology but are happy to pay for things that drive savings. There is a market entry point that has better alignment with the strengths of DTx and that is deploying DTx via value based care providers.”
Founded in 2016, BehaVR is a behavioral health-focused virtual reality company.
In December, it merged with OxfordVR and raised $13 million in Series B funding.
Last year, it received an FDA breakthrough designation for its VR therapy called gameChange, aimed at treating patients with schizophrenia spectrum disorders through virtual CBT.
