CMS issued its Medicare Physician Fee Schedule (MPFS) Final Rule for Calendar Year 2023. The final rule covers payment policies, payment rates and other provisions for services furnished on or after Jan. 1, 2023.
The rule includes national pricing for Current Procedural Terminology (“CPT”) codes 93241, 93243, 93245, and 93247. It also features an updated price of $260.35 for the extended external ECG patch, medical magnetic tape recorder (SD339) supply item. That benefits the San Francisco-based wearable heart monitor maker.
“The SD339 supply item price of $260.35 in the Final Rule is a positive improvement from the $245.69 price that CMS included in their Proposed Rule issued in July 2022,” the company said. “iRhythm is waiting for the Final Rule and accompanying addenda to be published on the Federal Register before providing further comments on the national pricing for CPT codes 93241, 93243, 93245, and 93247 and its potential impact to its business.”
iRhythm relies on two CPT codes to seek reimbursement for its Zio XT service. Code 93247 (wear time of greater than seven days and up to 15) applies. Additionally, it relies on code 93243 (for wear-time of greater than 48 hours and up to 7 days).
On the back of the news, iRhythm stock is down 7.5% at $117.31 per share in midday trading today. Still, that marks a rebound from yesterday when its shares took a dive on its third-quarter results. After hours yesterday, shares dipped to $105.09 apiece.
BTIG analyst Marie Thibault wrote in a report that, with the good news, the “Buy” rating remains with iRhythm stock.
“This is a positive update that we expect will remove any continued overhang from potential reimbursement risk,” said Thibault.