Cala Health, the bioelectronic medicine leader setting a new standard of patient care for chronic disease, closed 2021 with significant reimbursement accomplishments for patients. New coding and coverage by commercial and government payors makes it easier for physicians to prescribe and patients to afford Cala Health’s clinically proven treatment for essential tremor (ET), Cala Trio therapy.

Cala Trio therapy is an FDA-cleared wearable neuromodulation treatment that is clinically proven to be safe and effective at reducing hand tremor among adult patients with ET. Patients using Cala Trio therapy report improvements in their activities of daily living such as drinking, eating, writing, and socializing.

“Cala Trio therapy has given hope to many of my patients with essential tremor,” says Dr. Pravin Khemani, neurologist, movement disorder specialist at Swedish Neuroscience Institute. “The reimbursement wins that Cala Health has achieved in the past year make it easier for me to help my patients access this vital therapy.”

One of the biggest challenges has been affordable access to Cala Trio therapy due to lack of coverage and reimbursement. Cala Health’s coverage and reimbursement accomplishments throughout 2021 enable healthcare professionals and patients to more easily access therapy:

  • CMS granted and put into effect new Healthcare Common Procedure Coding System (HCPCS) codes for reimbursement of Cala Trio therapy. The codes cover a new reimbursement category for treatment with an “external upper limb tremor stimulator of the peripheral nerves of the wrist,” allowing payment for the Cala Trio device and devices like it.
  • The International Essential Tremor Foundation (IETF) includes Cala Trio therapy as a new, recommended therapeutic option for patients with ET in their Guidelines Advisory.
  • Cala Health received an accredited Provider Transaction Access Number (PTAN) which enables claims submissions for traditional Medicare Part B fee-for-service.
  • The Cala Trio device is in-network with MultiPlan, which is associated with nine out of 10 largest national insurance companies, and Zelis, which is associated with specialized PPO plans in the South. Benefits of in-network provider status include lower patient-out-of-pocket costs (frequently $0) and reduces the risk of reimbursement denial.
  • Cala Health is an accredited provider with major national health plans – Aetna, Blue Cross Blue Shield, United Healthcare, and others. Cala has been submitting and processing claims across all payors. Most patients had a copay less than $50.
  • The Veterans Administration (VA) has provided Cala Trio therapy to Veterans through the prosthetics department at individual VA centers.
  • The company now offers updated reimbursement support services to help patients obtain coverage through their insurance benefits.

In addition, Cala Trio therapy now offers a no obligation, 60-day evaluation period. If a patient determines the therapy is not right for them, they can simply return the product and the patient will not be financially responsible for any out-of-pocket fees.

The Cala Trio device, which uses transcutaneous afferent patterned stimulation (TAPS) therapy, is a novel treatment option for ET with lower and less variable costs compared with high-dose pharmacotherapies and surgical and non-reversible ablative procedures.

Cala Trio therapy is a qualified medical expense eligible for reimbursement through flexible spending and health savings accounts. Cala Health works with patients to understand their out-of-pocket cost. 

[Source(s): Cala Health, Business Wire]