“CMS Administrator Seema Verma announced Thursday the agency will overhaul coding regulations that she argues have hindered beneficiary access to new medical technologies.”
“Medical device companies will now be able to apply for a new permanent Healthcare Common Procedure Coding System (HCPCS) code twice a year, instead of annually. CMS also recently eliminated a requirement for a new product to have a 3% market share to be eligible for a new code…”
“Dive Insight:
The moves follow CMS’ hospital inpatient proposed rule last week, which included measures to speed coverage of breakthrough devices approved by FDA and boost Medicare reimbursement for novel technologies.
That rule also waives a requirement that new breakthrough devices demonstrate a substantial clinical improvement to receive coverage and add-on payment for two years while companies gather real-world evidence for an evidence profile to support further coverage…” Read the full article here.
Source: CMS to revamp coding for new medical technology – By David Lim, May 3, 2019. MedTech Dive.