Dexcom and Abbott both commended a change to Medicare policies that benefits continuous glucose monitor (CGM) users. Last month, the Centers for Medicare & Medicaid Services (CMS) published a final local coverage determination (LCD) expanding coverage for CGMs. The ruling has now gone into effect. CMS first published the LCD modifying coverage criteria for CGMs in […]
Centers for Medicare and Medicaid Services (CMS)
Expanded Medicare coverage for CGM to go into effect next month
The Centers for Medicare & Medicaid Services today published a final local coverage determination (LCD) expanding coverage for CGMs. New, expanded coverage of continuous glucose monitors (CGMs) under Medicare go into effect in April. CMS first published the LCD modifying coverage criteria for CGMs in October. The modification includes people with diabetes who receive insulin […]
Medicare to cover Dexcom G7 when it launches this week
Dexcom (Nasdaq:DXCM) announced today that Medicare offers coverage for its beneficiaries using the next-generation G7 CGM. The company announced the coming U.S. launch for G7 in a Super Bowl Commercial with musician Nick Jonas last night. It’s slated to roll out on Friday, Feb. 17. San Diego-based Dexcom met the category requirements for therapeutic continuous […]
Analysts: Abbott, Dexcom to benefit from proposed CMS decision on CGMs
Analysts see a new proposed local coverage determination (LCD) from CMS as a potential boost for Dexcom (Nasdaq:DXCM) and Abbott (NYSE:ABT). The Centers for Medicare and Medicaid Services (CMS) yesterday published the LCD modifying coverage criteria for continuous glucose monitors (CGMs). The modification includes people with diabetes who receive insulin treatment or have a history […]
New CMS codes for angina detection, tracking benefit Neovasc
Neovasc (Nasdaq:NVCN) announced today the Centers for Medicare and Medicaid Services (CMS) developed favorable new codes. The new codes cover the diagnosis and tracking of refractory angina. Neovasc develops the Reducer system for reducing angina symptoms in those with refractory angina. According to a news release, the codes will be utilized in the current, 10th […]
Nevro wins multiple coverage options for spinal cord stimulation
Nevro (NYSE:NVRO) today announced positive updates to multiple spinal cord stimulation (SCS) coverage policies. Aetna’s new SCS policy explicitly covers PDN (painful diabetic neuropathy), effective Aug. 29, 2022. Aetna’s health plan covers approximately 22 million commercial lives. Novitas and First Coast, Medicare Administrative Contractors (MACs) that represent 12 states, also provided a positive update. They […]
iRhythm stock up on positive news out of CMS
iRhythm Technologies (Nasdaq:IRTC) stock soared today on positive reimbursement news out of CMS as the agency makes 2023 fee schedule proposals. Truist analysts yesterday evening pointed to CMS proposing a national coverage determination (NCD) of $229 for the ZioXT wearable cardiac monitor. When incorporating the geographic physician payment adjustments, the analysts thought the actual payment […]
CMS will limit coverage of Aduhelm to people in clinical trials
The Centers for Medicare & Medicaid Services (CMS) released a national policy regarding coverage for Aduhelm (aducanumab). Controversy has surrounded the Alzheimer’s drug Aduhelm from Biogen (NSDQ:BIIB) and Eisai (TYO:4523) since the FDA’s fast track approval last year. Three members of an FDA advisory committee resigned after the approval. About a week later, nonprofit watchdog group Public Citizen called for high-profile resignations of […]
Analysts say high payor coverage, increased CGM adoption bodes well for Abbott, Dexcom
Analysts have suggested that companies like Abbott (NYSE:ABT) and Dexcom (Nasdaq:DXCM) may benefit from expected reimbursement progress. BTIG hosted a conference call with North Shore Medical Center (Salem, Massachusetts) Medical Director Dr. Gary Cohen and Healthcare Analytics, LLC analyst and consultant Dr. Joshua Cohen. The two experts offered insights into prescriber and patient interest in continuous glucose monitors (CGMs) […]
Medtronic announces recent reimbursement wins for CGMs in a number of geographies
Medtronic (NYSE:MDT) announced today that reimbursement for its CGMs has been expanded or initiated across a number of countries. Earlier this month, the Ontario, Canada provincial government announced a comprehensive reimbursement program for continuous glucose monitoring (CGM) for eligible residents who have type 1 diabetes, adding to a similar program for those with type 1 […]
Pear Therapeutics advances in efforts to get CMS to cover prescription digital therapeutics
Pear Therapeutics (NSDQ:PEAR) announced that the Centers for Medicare & Medicaid Services (CMS) established new coding relevant to its prescription digital therapeutics (PDTs). CMS established a new Level II Healthcare Common Procedure Coding System (HCPCS) code to describe prescription digital behavioral therapy — FDA-cleared — per course of treatment, which extends to PDTs including Pear’s reSET, […]
