Highmark Becomes 1st Insurer to Cover AppliedVR's RelieVRx for Chronic Back Pain

This decision makes the FDA-authorized virtual reality (VR) therapy accessible to over 4 million Highmark plan members.

Pittsburgh-based health insurer Highmark has become the first commercial payer to cover AppliedVR's RelieVRx device for chronic lower back pain. 

This decision makes the FDA-authorized virtual reality (VR) therapy accessible to over 4 million Highmark plan members.

RelieVRx, developed by the immersive therapy startup AppliedVR, is designed to address chronic lower back pain through a 56-session program. This program, conducted at home, combines VR sessions with exercises to manage the bio-psycho-social aspects of pain.

Highmark’s decision follows an evaluation of AppliedVR's clinical studies, demonstrating that RelieVRx significantly reduces pain intensity and interference. 

The device, used with a headset and software, is now available to eligible members aged 18 and older without requiring prior authorization from healthcare providers.

Clinical Evidence

Matthew Stoudt, co-founder and CEO of AppliedVR, said, “Highmark is one of the more forward-thinking plans out there. They had some real challenges and needs in the marketplace from their patient population. We’re super excited to have them as the first major player to step up and say we recognize the value of what you’re bringing in, the efficacy of what you’re bringing in. We know it makes sense for patients.’’

The introduction of RelieVRx into Highmark's coverage network is expected to influence other commercial health plans and employers to consider VR-based therapy. 

Matt Fickie, senior medical director for Highmark, said, “We are committed to leveraging technology to enhance health outcomes while reducing costs. RelieVRx from AppliedVR provides our members suffering from chronic low back pain a scientifically backed, in-home, immersive non-opioid treatment option.”

RelieVRx's inclusion in Highmark’s network follows a comprehensive assessment of its clinical effectiveness. The device received FDA clearance in 2021. 

AppliedVR's extensive clinical trials, including a study with over 1,000 participants, found that RelieVRx produces meaningful improvements in pain management across diverse patient groups.

AppliedVR also achieved a breakthrough with the Centers for Medicare and Medicaid Services (CMS) in March 2023, securing a unique Healthcare Common Procedure Coding System (HCPCS) Level II code for RelieVRx. This coding facilitates its classification as durable medical equipment, streamlining the reimbursement process.

Future Plans

Stoudt noted that AppliedVR plans to focus regionally in markets where Highmark has significant influence, including Pennsylvania, Delaware, West Virginia, and New York. 

Furthermore, the company aims to collaborate with local healthcare providers to integrate RelieVRx effectively into their pain management protocols.

The adoption of RelieVRx by Highmark aligns with broader trends of increasing coverage for innovative digital therapies. 

Highmark has previously expanded insurance coverage to include other prescription digital therapeutics and recently began covering tools like Cognoa’s Canvas Dx for autism diagnostics.