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Sleep apnea device payments under Medicare got richer (comparatively) for one device manufacturer than its competitors.
Clipped from: https://www.globenewswire.com/news-release/2020/12/09/2142686/0/en/Itamar-Medical-Comments-on-U-S-Centers-for-Medicare-Medicaid-Services-CMS-2021-Fee-Schedule-with-Reimbursement-Update-for-Home-Sleep-Apnea-Testing.html
WatchPAT™ to effectively maintain current reimbursement levels despite broader reduction in conversion rates
CAESAREA, Israel, Dec. 09, 2020 (GLOBE NEWSWIRE) — Itamar Medical Ltd. (NASDAQ and TASE: ITMR), a leading medical device and digital health company focused on the integration of sleep apnea management into the cardiac patient care pathway, today commented on the recent release of the 2021 Physician Fee Schedule from the U.S. Centers for Medicare & Medicaid Services (CMS). This Fee Schedule represents the third year of a four-year proposed plan to reevaluate reimbursement in home sleep apnea diagnostic codes. The final changes will become effective on January 1, 2021.
The 2021 Fee Schedule further widens the gap between the CPT-95800 used with Itamar Medical’s WatchPATTM device of approximately $163, a -3.5% decrease from 2020, compared to CPT-code 95806 used with competitive Home Sleep Apnea Testing (HSAT) devices of approximately $95, a -20% decrease from 2020.
In the 2021 Fee Schedule, the professional RVUs of both 95800 and 95806 were slightly increased (about 1%), but for the first time in the last three years of adjustments, have CPT 95800 Technical Component RVUs increased by 9.5% while CPT-95806 technical RVUs were significantly reduced (18.8%). In addition to the RVUs, the rates were further impacted by the broader reduction in the CMS conversion factor from 36.09 to 32.41 resulting in the final fee schedule rates.
“The increase in 95800 RVUs will allow providers utilizing our WatchPAT devices to maintain the current reimbursement levels despite the broader reduction in conversion rates, allowing them to continue to diagnose their patients and improve lives,” said Gilad Glick, CEO of Itamar Medical. “The changes to the 2021 Physician Fee Schedule for code 95800 continue the steady trend we have seen since 2017, and we expect to see continued support, thereby expanding the broad use of the WatchPAT device.”
The below table shows the new reimbursement fees for Home Sleep Apnea Testing. For more information about the CMS update, you may visit CMS website:
A 2021 Reimbursement and Coding Guide can be also found on the Itamar Medical website:
About Itamar Medical Ltd.
Itamar Medical is a medical technology company focused on the development and commercialization of non-invasive medical devices and solutions to aid in the diagnosis of respiratory sleep disorders. Itamar Medical commercializes a digital healthcare platform to facilitate the continuum of care for effective sleep apnea management with a focus on the core sleep, cardiology and direct to consumer markets. Itamar Medical offers a Total Sleep Solution to help physicians provide comprehensive sleep apnea management in a variety of clinical environments to optimize patient care and reduce healthcare system costs. The Company’s key product, WatchPAT, is commercially available within major markets including the US, Japan, and Europe. Itamar Medical is a public company traded on the Nasdaq and on the Tel Aviv Stock Exchanges, and is based in Caesarea, Israel with U.S. headquarters based in Atlanta, GA. For additional information visit www.itamar-medical.com
This press release contains forward-looking statements within the meaning of the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995 and other applicable securities laws. Statements preceded by, followed by, or that otherwise include the words “believes”, “expects”, “anticipates”, “intends”, “estimates”, “plans”, and similar expressions or future or conditional verbs such as “will”, “should”, “would”, “may” and “could” are generally forward-looking in nature and not historical facts. For example, when we discuss expanding the broad use of the WatchPAT, we are using forward-looking statements. Because such statements deal with future events, they are subject to various risks, uncertainties and assumptions, including events and circumstances out of Itamar Medical’s control and actual results, expressed or implied by such forward-looking statements, could differ materially from Itamar Medical’s current expectations. Factors that could cause or contribute to such differences include, but are not limited to, risks, uncertainties and assumptions discussed from time to time by us in reports filed with, or furnished to, the U.S. Securities and Exchange Commission (“SEC”) and the Israel Securities Authority (“ISA”), including our latest Annual Report on Form 20-F which is on file with the SEC and the ISA. Except as otherwise required by law, we undertake no obligation to publicly release any revisions to these forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events.
Itamar Medical Investor Relations Contact (U.S.)
Leigh Salvo or Caroline Paul
A photo accompanying this announcement is available at https://www.globenewswire.com/NewsRoom/AttachmentNg/8ceb62fb-085a-4317-bace-c311667cd0a0