LIVN (US)

Medicare Administrative Contractor (WPS) WPS – with jurisdiction over ~13% of INSP implants – this morning updated its hypoglossal nerve LCD billing article to instruct physicians to bill for Inspire V services with a -52…

We view Inspire Medical’s (INSP) commentary / guidance on the risk of persistent coding and reimbursement headwinds throughout 2026 (-$120M to -$150M) as appropriately characterizing the current uncertainty, with limited prospects for near-term clarity. In…

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…

Having received a large number of questions on whether Medicare Administrative Contractors (MAC) might refuse to cover INSP’s Inspire V device under CPT 64568 following CMS’s recent facility rate increase via assignment to a New…