Nidra TOMAC device

Hi there,
I just discovered this thread. My doctor submitted the prescription for the Nidra and the company has called me to set it up. However, even with 3 phone calls to Medicare, I can't get any verification that it will be covered. I've had RlS for years and I'm on pregabalin and ropinirole. My doc doesn't want to increase the ropinirole any higher. When I gave the medicare persons the codes and the provider number, they couldn't find anything. Do I just say yes to the Nidra consultant and hope for the best? I don't want a huge bill if it's not covered. Why can't I get a pre-approval?
thank you!

Hi there,
I just discovered this thread. My doctor submitted the prescription for the Nidra and the company has called me to set it up. However, even with 3 phone calls to Medicare, I can't get any verification that it will be covered. I've had RlS for years and I'm on pregabalin and ropinirole. My doc doesn't want to increase the ropinirole any higher. When I gave the medicare persons the codes and the provider number, they couldn't find anything. Do I just say yes to the Nidra consultant and hope for the best? I don't want a huge bill if it's not covered. Why can't I get a pre-approval?
thank you!

@lk8 Why don't you call the Noctrix Company (it's in California--it's address and phone number can be googled)? They make the Nidra, so "sales" are in the best interest in the company. From my limited knowledge, it seems a number of insurance claims have been denied. Noctrix will have the best handle on how to deal with insurance and they (for me) have been incredibly nice and helpful when I communicated with them. (You probably read that I'm one of Nidra's success stories from my postings--I hope you get the device and I hope it is equally effective for you).

@missjb thanks for your reply. I have called the Noctrix company several times and Summer keeps saying that Noctrix has been approved by medicare and that they do NOT do pre-approvals. She also said that 'their' nurse approved my prescription. I told her to go ahead and send it to me and if medicare doesn't approve it, I will send it back and I will not pay for anything. She said that would be fine, but I have nothing in writing. My concern is that I've heard so many are denied.

Hi there,
I just discovered this thread. My doctor submitted the prescription for the Nidra and the company has called me to set it up. However, even with 3 phone calls to Medicare, I can't get any verification that it will be covered. I've had RlS for years and I'm on pregabalin and ropinirole. My doc doesn't want to increase the ropinirole any higher. When I gave the medicare persons the codes and the provider number, they couldn't find anything. Do I just say yes to the Nidra consultant and hope for the best? I don't want a huge bill if it's not covered. Why can't I get a pre-approval?
thank you!

@lk8 Pre-approval was not part of the process when I got Nidra.

My perception is "approval" has been an issue for some people. Initially, I got this impression from the Noctrix nurse I spoke with. She said it was important that the prescribing doctor include patient history--which someone at the Noctrix Co was going to evaluate. Maybe, this was because Noctrix wanted to build a good reputation with Medicare--only have qualified patients apply for insurance funding.

My doctor evidently did this acceptably because it was only a matter of 3 weeks between submission of the prescription and picking mine up.

Or, maybe Medicare looks at past billing related to RLS to see if there is history. I don't know how insurance works--deciding to approve or deny. But, I did have years of Medicare billing specifically for RLS care.

In general, I have read that all insurances deny some claims and that appealing is successful more times than not.

Most of my contact with Noctrix has been email--you could call one more time and ask Summer (or someone) to email what was said over the phone (give her your email or ask for hers) and then you would have this verbal agreement in writing. (Emails count in a legal sense as much as a paper letter).

I can understand the possible expense making you nervous--particularly not knowing if Nidra will work for you (until you try it).

Really, I think the company is trying to build a good reputation, and they will stand by what Summer told you.

My sense of Noctrix from the support I have been given is that they are honorable. I wouldn't post about them in glowing terms if my experience hadn't been so good. Also, I googled the Noctrix board a year ago and I was impressed with their resumes. I don't remember exact details but schools like MIT and Stanford come to mind.

My own experience was getting an email address somehow (after I read about Nidra in research articles) and then having a phone call with a nurse, who explained Nidra was only available in certain states, but not where I live--yet. I said I could travel to a state where it was available (Ohio), but she said it still wasn't possible. A year later, Noctrix contacted me and gave me permission to start the prescription process and then pick mine up in Ohio. I was very impressed that someone in the company followed up (without any prompting from me)--an entire year later.

My doctor did mention that some of his patients have been denied Nidra approval by insurance. But I have no idea how this looks in actual numbers. Is it "many" or does my doctor just think all his prescriptions should be approved (he is a RLS expert--so, really, they should).

I'm going to start a thread for people with Nidra so we can compare our Nidra experiences and maybe be helpful to people just starting out (like you will be). For me, there was a process of getting used to it. Then, the neuromodulation (change in my brain, reducing the frequency and severity) was months and months in coming.

Some people do not have the success I have had. I hope, lk8, that you will. Please do keep us posted!

Hi again, mikayla68

I laughed out loud reading "do you work for Nidra?" I'm several years older than you are and I work for no one --except my husband on occasion and truthfully, when my RLS was really bad and I was so sleep deprived, he did almost all of the work in our household.

My relationship with the Noctrix Company (that makes the Nidra) is purely one of gratitude. I mention Nidra on our forum with enthusiasm because, for me, Nidra (along with medication) has reduced my amount of RLS symptoms to very, very few--which has given me back my ability to sleep. ..I wish I could also get back the last 15 years... but that's another story--sleep is so much better, but now age is catching up with me.

I suggest people contact the Noctrix Company with questions or problems because my communication with them was so favorable--not because I have any connection to them (except as one of their many customers).

It sounds like the Nidra made your calf muscles contract and then get locked into contractions--which does sound very painful. Bad enough to have one problem--you don't need to trade that problem for another (particularly one which is worse.)

During my last conversation with my doctor he told me that he has prescribed the Nidra for patients who received no benefit from it. Stuff like that makes me curious: why has it helped me (so much) and then not all other people who suffer for RLS?

Well, I think your doctor was forward thinking to have prescribed the Nidra, even though it was not helpful for you. Hopefully, this means he (or she) will continue to try treatments and maybe find something that gives you as much relief as I have now. I certainly hope so.

Thank you for sharing your experience.

Wishing you the best!

@lk8 Hi lk8, Yes, Nidra--well the Noctrix Co that made Nidra--was sold to ResMed last month (June 2026) for 340 million dollars! ResMed makes C-PAP equipment, I understand. I hope the high standards of service I've experienced continues under the new ownership.

I hope this isn't a duplicate question I've asked you before, lk8, but do you see a RLS specialist? Since you live in Florida, I wonder if you have your RLS treated by a Mayo doctor--a RLS specialist?

My doctor does telemedicine (via the internet) also in Florida (he only does telemedicine, has no physical office--and, he is not affiliated with Mayo). He is a fabulous RLS expert. He literally co-wrote the latest RLS Guideline. He only does private pay, however--does not deal with insurance--whether or not that would be an option for you. He does not overcharge, IMO, and is more available when managing care of someone experiencing RLS difficulties than a "traditional" insurance-based doctor would be. I mention him to you because you live in Florida. He is only licensed in Florida, Michigan and Ohio. And, I mention because you are not doing well. He also specializes in "not doing well."

I totally credit my successful RLS management to the fact I sought out a RLS specialist, instead of acquiescing when my primary doc tried to push Requip (aka ropinirole) on me.

You have read about augmentation, haven't you? The RLS Foundation website has very good descriptions, if you haven't.

Although the combination of medication and Nidra has been so successful for me, the medication I take was well established in my treatment plan before I got my Nidra and this medication was the right one for me. In comparison, it doesn't sound to me like your medication is doing a lot for you right now.

I'm speaking from my own experience--and I know many on this forum respond differently to different medications--so what helped me might not help others--but I wonder if your need a medication "adjustment" before your Nidra--so the Nidra can work the best for you...

I don't know if --because our symptoms are so similar--if you took buprenorphine like I do (as Suboxone) if that would do more for you. I never took Requip, so I don't know how someone weans off that and transitions to a better drug, but from what I read on this forum, it can be a process (but one that is certainly do-able) That's why I wonder if you have expert RLS care.

Because--> on the combination of Nidra and my medication I had so many symptom-free nights, I tried to decrease the amount of medication I take and my symptoms returned. Not as bad or frequent, but certainly not as wonderful as "no symptoms." So, I went back to the higher dose. This is why I think you might do better with your medication changed (or tweaked or something) before the Nidra. For me, Nidra couldn't do the job without adequate/appropriate medication.

I do know I have great sympathy for you because my own symptoms have been so horrible--so yours must be as well. I know you are not having an easy time of it.

My doctor told me that someone (maybe at Duke?) was studying people with painful RLS as kind of a separate category and there was some thought that we have an endorphin shortage and that opiates or opioids are more effective treatment for RLS sufferers with a painful presentation. Buprenorphine is an opioid used mainly for drug addictions, like methadone but with less side effects. When used for RLS, the dose is much smaller than for a recovering addict.

The Requip you are taking has something to do with dopamine, not endorphins. This is all conjecture, at this point, but taking buprenorphine has helped several on our forum along with me.

I look forward to when RLS is better understood and universally treated with the success I've experienced. I hope sharing my experience gives some help to you, lk8. Please stay in touch.