Effective Oct. 1, 2020, and ranging over a three-year duration, Medicare is slated to provide an add-on payment for Barostim Neo worth up to 65% of the device cost (up to a maximum amount allowed of $22,750) in addition to the Medicare severity-diagnosis related group (MS-DRG) payment for the procedure.
The overall procedure reimbursement for the Minneapolis-based company’s implant is expected to range between $39,895 and $44,170, according to a news release. Additionally, CMS proposed national coverage determination (NCD) for breakthrough device designation treatments like Barostim Neo.
Barostim Neo uses patented technology to send electrical pulses to baroreceptors in the wall of the carotid artery in an effort to restore balance to the automatic nervous system and improve the symptoms of heart failure. It received breakthrough device designation from the FDA in 2016.
The device falls under the recently proposed national Medicare coverage of innovative technology (MCIT) rule for breakthrough implantables. CVRx said Barostim Neo is already widely reimbursed on a claim-by-claim adjudication basis, but the NCD will eliminate the need for adjudication in such a process.