An update to UnitedHealthcare’s medical coverage policy said spinal cord stimulation wouldn’t be covered for treating chronic intractable back pain without prior spine surgery, according to an Oct. 10 news release. Previously, there wasn’t a UnitedHealthcare coverage policy for nonspecific back pain patients, and the news will affect Nevro’s 2023 revenues between “ow to mid-single digit millions of dollars.”
Nevro’s Senza spinal cord stimulation system earned FDA approval for nonsurgical refractory back pain in January. The approval came after the company conducted a 12-month study into its system’s treatment of back pain. The company said study participants saw improvements in pain relief, quality of life and a reduction in daily opioid use compared to conventional treatments.
“We regularly review new clinical evidence and update our medical policies to ensure they reflect the most current published evidence-based medicine,” a UnitedHealthcare spokesperson told Becker’s. “Depending on the specific coverage determination and the terms of the member’s benefit plan, providers and members may have the right to appeal, providing information to support the requested treatment.”
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