Medtech


November 29, 2025

DXCM, TNDM, BBNX, RMD, COLOB.DC, CTEC.LN: Competitive Bidding Comes for CGM, Pumps, & More

By John Leppard

With CMS finalizing [Fact Sheet, Final Rule] its intention to include continuous glucose monitors (CGM) [DXCM, ABT], insulin pumps [TNDM, BBNX], and urological / ostomy supplies [COLOB.DC, CTEC.LN] in the next round of the Competitive…

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November 25, 2025

[DXCM, ABT] CGM Report Suggest Competitive Bidding Coming

By John Leppard

Publication of the HHS Office of Inspector General’s (OIG) long-awaited report today on Medicare payments for continuous glucose monitors (CGM): (A) bolsters our long-held view that the agency intends to finalize its intention to include…

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November 22, 2025

INSP, NYXH, LIVN: Surprise (But Short Lived?) Payment Win

By John Leppard

CMS’s surprise decision to reassign cranial nerve neurostimulator code CPT 64568 to a $45K New Tech APC (+48% YoY) represents a significant 2026 tailwind for both vagus (VNS) [LIVN’s Sentiva] and hypoglossal nerve stimulation (HNS)…

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November 18, 2025

IRTC Coverage Risks: Smoke or Fire?

By John Leppard

With shares of IRTC pressured yesterday amid speculation on the risks associated with a Sept. 25 draft local coverage determination (LCD), we suspect the final version – likely released in March / April – will…

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November 14, 2025

MMSI: Wrapsody Outpatient Margin Implications

By John Leppard

Consistent with our long-held expectations [here, here], MMSI’s disclosure yesterday that CMS has “deferred” a decision on its Wrapsody transitional pass-through (TPT) payment application suggests a greater likelihood that it was denied, in our view,…

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November 13, 2025

GKOS: iDose Medicare Coverage Expectations

By John Leppard

Yesterday’s Medicare Administrative Contractor (MAC) advisory committee (CAC) meeting on GKOS’s iDose bolsters our relatively sanguine outlook going into the event [here, here], and would expect any headwinds from a likely mid-2026 draft local coverage…

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November 3, 2025

[MDXG, CTEC.LN, COLOB.C] Skin Substitute Rates & Additional Risks

By John Leppard

Consistent with our expectations, we view MDXG and CTEC.LN as most exposed to CMS’s finalized Physician Fee Schedule (PFS) policy to reduce skin substitute payments from current Average Sales Price (ASP) / invoice levels to…

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November 3, 2025

PRCT: Nominal Rates vs Opportunity Costs

By John Leppard

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,…

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October 31, 2025

Merit Medical (MMSI): Net vs List Price in Pass-Through Payments

By John Leppard

We remain skeptical of MMSI’s prospects for a Wrapsody Medicare hospital outpatient transitional pass-through (TPT) payment following company confirmation last night that its application relies on an $8K list price, rather than the $5.8K net…

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October 29, 2025

[MDT, Otsuka] Renal Denervation: Broad Coverage, With New Guardrails

By John Leppard

We view CMS’s final coverage policy for renal denervation (RDN) [Medtronic (MDT), Otsuka (4578.JT)] as largely consistent with the initial proposal, but with some modest new guardrails that may incrementally slow utilization and delay /…

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