November 3, 2025
PRCT: Nominal Rates vs Opportunity Costs
CMS’s final CY26 Physician Fee Schedule (PFS) released late Friday will reduce payments for PRCT Aquablation services by -29% in 2026, going from a volume-weighted $765 across the seven Medicare Administrative Contractors (MACs) to $542,…
July 16, 2025
Misses For LNTH, LIVN, PRCT, Wins for BSX / MDT
CMS’s CY26 hospital outpatient proposal last night hews closely to our expectations going in: INSP: With the company targeting use of LIVN’s cranial nerve code for its Inspire V device, payment group reassignment likely would…
July 14, 2025
PRCT: Pro Fee -28%, Competitor -25%
CMS’s draft CY26 Physician Fee Schedule (PFS) released this evening would reduce payments for PRCT’s Aquablation by -28% in 2026, going from a volume-weighted average of $765 across the seven Medicare Administrative Contractors (MACs) to…
June 30, 2025
[LIVN, INSP, GMED, MMSI, BSX, MDT] CMS Prior Auth Demo Device Headwinds
We view CMS’s new Medicare prior authorization model – announced late Friday and scheduled for implementation Jan. 1, 2026 – as an incremental headwind for device manufacturers within the selected therapeutic and geographic areas, which…
April 14, 2025
Medtech & Medicare Inpatient Implications
Friday’s draft FY26 rate rule for Medicare inpatient hospital services brings incremental benefits for the likes of BSX, DXCM, ABT, and MMSI through proposed endorsement of new technology add-on payments (NTAP) that we expect to…
March 31, 2025
Procept Biorobotics: Expecting ~20% Medicare Rate Cut
With CMS likely to propose a new Medicare physician payment rate for PRCT’s Aquablation in early July – with a final policy in early Nov. and rates effective Jan. 1, 2026 – we expect to…
January 6, 2025
Conference Policy Prep Pack: Devices, Diagnostics, & Tools
With medical device, equipment, diagnostics, and life science tools (LST) companies set to descend on San Francisco next week for a key investor conference, below we provide a set of significant policy-related questions for clients…
November 25, 2024
RFK’s Medical Coding Reforms: Don’t Hold Your Breath
Key Takeaways: With investors questioning RFK’s reported plans to restructure the medical coding system used by Medicare, Medicaid, and commercial health insurers , we remain highly skeptical of meaningful changes within the next 5-10 years,…
November 4, 2024
[MDT, BSX, LIVN, CVRX] Medtech Medicare Rule Puts & Takes
Key Takeaways: We appear to have run the table with our pre-rule expectations [here, here] following CMS’s release Friday of its CY25 hospital outpatient payment rule, which includes the following company-specific implications: MDT & Otsuka…
October 28, 2024
[BSX, MDT, LIVN, INSP, CVRX] Catalyst Watch: Medicare Rate Rule Prep Pack
Key Takeaways: With CMS likely to release its final CY25 hospital outpatient payment rule by Friday (typically aftermarket) or early next week, we offer the following expectations for key product payment decisions, listed in market…