Coverage for VNS Therapy for the adjunctive long-term treatment of chronic or recurrent depression for patients over the age of 18 who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments is likely to be based on each individual's unique clinical circumstances until payers develop their own coverage policies. Case-by-case approvals have been obtained from more than 300 different payers since FDA approval in July 2005.
Several appeals steps may be required in order to gain coverage for VNS Therapy in TRD, and the process and number of steps vary from state to state and from plan to plan. A Regional Case Manager can help you determine if specific insurance plans may cover aspects of the VNS Therapy procedure by verifying your patients’ benefits and determining the best way to pursue approval.
Please contact your Regional Case Manager at 1-877-NOW-4VNS (1-877-669-4867).
Information can be found at the links below:
- Coding (Physician and Hospital)
- Frequently Asked Questions
(FDA Approval, Insurance Verification and Education Authorization (IVEA) & Flow Chart, Letter of Medical Necessity (LOMN), HIPAA, Contact Information and Other Links)
Hear from a VNS Therapy case manager
"Hello. I'm Julie. I'm a Licensed Nurse and a case manager for VNS Therapy.
The way the nurse case manager helps in ongoing education is a vital role with the VNS Therapy. One of our primary roles is education…we want to let the patient know that when they call in, we're available to help them through all steps of education."
Insurance Verification and Education Authorization (IVEA)
A Regional Case Manager is available to work with you to verify insurance benefits and determine the best process for pursuing coverage of VNS Therapy in TRD.
Regional Case Manager
The Regional Case Manager is available to work with psychiatrists to submit prior authorization for VNS Therapy on a case-by-case basis as appropriate. In addition, the Regional Case Manager will make educational materials available to you and your patients throughout the decision-making process.
Please contact a nurse Regional Case Manager if you have reimbursement questions that are not answered by the resources on our Web site. You may contact us by phone at (877) NOW-4VNS (877-669-4867).
© Cyberonics, Inc. 2007