Massachusetts medical device maker Hologic’s (NSDQ:HOLX) is eying a potential Medicare reimbursement win for its breast tomosynthesis systems after landing an early milestone.
The American Medical Assn.’s CPT Editorial panel tentatively accepted Hologic’s application for breast tomosynthesis, granting the technology 3 Category I CPT codes that include screening and diagnostic procedures, Hologic said.
"The Summary of Panel Actions is a preliminary step and codes are not assigned, nor is exact wording finalized, until just prior to the publication of the CPT Professional Edition 2015," according to a company statement. "The Medicare payment rates associated with the breast tomosynthesis codes will not be posted until the Medicare Physician Fee Schedule Final Rule is issued by the Centers for Medicare & Medicaid Services on or around November 1, 2014."
The news is a good omen for Hologic, but analysts tallied it as a minor win for a technology that still faces hurdles. Mammogram screenings seem to be in decline as patients continue to lack access ahead of implementation of the Affordable Care Act. Ongoing debates about the value and potential risks of the technology have also contributed to lowering volumes, according to Cantor Fitzgerald analyst Jeremy Feffer.
"Although an incremental positive for HOLX, our overall views on the Breast Health business are unchanged, as hospitals continue to invest capex dollars strategically, and renewed questions about the use of mammography as a screening tool may keep downward pressure on volume trends," Feffer wrote in a note to investors. "We believe that a more vigorous debate may further pressure volumes this year, which from HOLX’s standpoint, may move mammography lower on hospitals’ capital spending priority lists and thus further lengthen replacement cycles."
Hologic has struggled in recent months, swinging to a Q1 loss on a 3% decline in revenues. HOLX shares gained 1.4% today, trading at $21.91 as of about 1:50 p.m. The stock has lost 1.9% since the start of the year.
