All PlansCoverageMedium impact
Immersive Virtual Reality Therapy for Chronic Lower Back Pain
Blue Cross & Blue Shield of Mississippi·MS · Pain Management, Physical Therapy, PM&R (Physical Medicine & Rehab) +1 more·Medical Policy
Effective date
Aug 1, 2026
We identified it
Aug 12, 2026
Summary
Blue Cross Blue Shield has added a new policy (A.3.03.06) classifying FDA-authorized prescription virtual reality therapeutics for chronic lower back pain as investigational. RelieVRx is currently the only FDA-cleared product in this category. Billing teams must recognize CPT 40770T as an investigational code and ensure proper prior authorization and medical necessity documentation before claims submission.
Action Required
By August 1, 2026: Billing team must update billing system and encounter templates to flag CPT 40770T as requiring prior authorization. 1) Add CPT 40770T to the investigational codes list in billing software with mandatory prior auth requirement. 2) Update provider documentation templates to ensure prescribers document medical necessity for chronic lower back pain treatment per the policy guidelines (technology must improve net health outcome and be as beneficial as established alternatives). 3) Train billing and authorization staff that RelieVRx is the only currently FDA-authorized product meeting policy scope criteria. 4) Establish process to verify patient age (18+) and that product is prescribed by healthcare provider before claim submission. Failure to obtain prior authorization will result in claim denials under investigational policy status.