Medicare to Cover Deep Brain Stimulation for Essential Tremor and Parkinson's Disease

February 6, 2003 - The Centers for Medicare & Medicaid Services (CMS) announced today it intends to cover deep brain stimulation for patients with severe disabling symptoms from essential tremor disorder or Parkinson's disease.  Coverage for this procedure will be limited to patients who have received the best medical care but still have significant difficulty in performing daily activities.

"This coverage decision will help many of the Medicare beneficiaries hit hardest by Parkinson's disease and essential tremor disorder and dramatically improve their quality of life," Health and Human Services Secretary Tommy G. Thompson said.  "Our goal is to make sure Medicare beneficiaries are given appropriate access to new technologies that can aid their treatment and recovery."

Deep brain stimulation uses implanted electrodes to deliver electrical stimulation to certain targeted areas of the brain.  The system is composed of implanted brain electrodes, an electrical stimulator placed in the upper chest area, and an implanted extension wire connecting the electrodes to the stimulator.

Parkinson's disease is a degenerative brain disorder characterized by tremor, rigidity, and a gradual loss of spontaneous movement.  Essential tremor disorder is a progressive, disabling tremor that most often affects the hands. A variety of medications provide relief from the symptoms of both conditions, but no drug can stop their progression.

"Deep brain stimulation provides a new option for Parkinson's disease and essential tremor disorder patients who have reached maximum benefit from medical treatment and continue to have severe disabling symptoms from these disorders or unacceptable side effects from medications," said Sean Tunis, MD, acting CMS chief clinical officer.

This new policy was initiated by a request from a Medicare beneficiary and is based on a review of the scientific evidence, testimony from Parkinson's patients and expert clinical opinion. The Medicare Coverage Advisory Committee, a panel of leading private sector experts, also concluded that deep brain stimulation improved health outcomes by a substantial margin for a well-defined set of Medicare patients with Parkinson's disease of essential tremor disorder.

This benefit will be implemented later through instructions to the private contractors who process and pay Medicare claims.  More information about this decision can be found on the Medicare web site.

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