January 22, 2026
INSP: CMS Update Makes Pricing / Volumes a Bigger Lift
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,…
January 20, 2026
Tools, Dx, & Labs: Lawmakers Come Through
The bipartisan, bicameral FY26 HHS appropriations bill text released this morning is largely consistent with our expectations, with incremental upside for life science tools (LST), diagnostics, and clinical labs. More specifically, the legislation – which…
January 9, 2026
Conference Policy Prep Pack: Medtech & Biopharma
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…
January 8, 2026
INSP: MAC Feedback Points to Lower Doc & Facility Rates
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…
December 30, 2025
INSP: How The MAC Tides Have Turned
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…
December 18, 2025
INSP: More MAC Confusion
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…
December 16, 2025
Skin Substitute Coverage: Pyrrhic Victory?
While an improvement from the skin substitute coverage policies that have been delayed since Nov. 2024, CMS’s updated intentions risk prolonging uncertainty for the likes of CTEC.LN, MDXG, and ORGO, as well as benefits for…
December 16, 2025
EW, ABT, MDT: TAVR Coverage Coming
Coming roughly in line with our timing expectations outlined in early June (admittedly, a quarter or so early), we would expect CMS’s reopening of its transcatheter aortic valve replacement (TAVR) coverage policy to provide greater…
December 12, 2025
INSP: Inspire V Coverage Questions Answered
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…
December 10, 2025
INSP / LIVN: Pricing, Payments & Policy
With shares of INSP up ~60% since CMS announced a 48% hospital rate increase for Inspire V procedures billed under CPT 64568 in CY26 (+58% for ASCs), we continue to believe that this will be…