INSP (US)

Amid persistent investor questions on Medicare Administrative Contractor (MAC) billing / coding requirements for Inspire Medical’s (INSP) Inspire V device, we continue to believe that the MACs will ultimately instruct providers to use the -52…

While we view today’s update of Medicare Administrative Contractor (MAC) WPS’s billing and coding article for hypoglossal nerve stimulation (HGNS) – omitting requirements that physicians bill using a -52 (reduced work) modifier – as directionally…

As we had anticipated, the American Medical Association’s (AMA) CPT Editorial Panel will evaluate the creation of a new reimbursement code to describe single lead hypoglossal nerve neurostimulation (HGNS) devices (e.g., INSP’s Inspire V) at…

We see little practical reimbursement impact for INSP from CMS’s announcement this morning that it will be creating a set of new facility level C-codes for newer generation hypoglossal nerve stimulation (HGNS) device services (e.g.,…

With INSP confirming our suspicion last night that MACs will ultimately require Inspire V procedures to be billed under CPT 64582 with a -52 (reduced work) modifier, we would expect this to translate into a…

CMS’s update this morning – indicating that CPT 64568 is not covered for obstructive sleep apnea under any national coverage determination (NCD) – is in keeping with the view we articulated just two weeks ago,…

With medtech and biopharma companies set to descend on San Francisco next week, below we provide a set of significant policy-related questions for clients to ask management, the answers to which will inform company growth…

Following repeated outreach to Medicare Administrative Contractor (MAC) public inquiry mailboxes, feedback from WPS – responsible for ~13% of INSP services – bolsters our view that the company is unlikely to be able to take…

With Medicare Administrative Contractor (MAC) WPS – responsible for ~13% of INSP claims – now joining Noridian (17%), NGS (9%), and CGS (6%) in removing cranial nerve code 64568 from its hypoglossal obstructive sleep apnea…

Despite this morning’s billing article updates from Medicare Administrative Contractors (MACs) Noridian [here] and CGS [here] – removing CPT 64568 from the list of covered codes for hypoglossal nerve stimulation (HGNS) for obstructive sleep apnea…