Medtech

With Noridian (17% of services) including instructions that physicians bill for Inspire Medical’s (INSP) Inspire V procedure with a -52 (reduced work / payment) modifier this morning, following a similar update from WPS on May…

Following last week’s draft LCDs requiring Glaukos (GKOS) iDose patients to first fail ≥ 2 topical medications and selective laser trabeculoplasty (SLT), the absence of reliable data on the proportion of existing patients that can…

The draft local coverage decision (LCD) issued today by five MACs with jurisdiction over ~70% of Glaukos (GKOS) Medicare FFS volumes is both better and worse than we had anticipated for the company’s growing iDose…

With today’s rejection of INSP’s coding application for the Inspire V device by the AMA, the company’s last opportunity to have a new code take effect by Jan. 1, 2028 will be to secure approval…

We suspect iRhythm (IRTC) faces both relief and little more than a modest growth headwind following a finalized local coverage determination (LCD) from its primary Medicare Administrative Contractor (MAC) this morning. In keeping with expectations…

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…

The joint CMS / FDA press release this morning outlining the Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway for breakthrough medical devices strikes us more as a rebranding of the existing transitional…

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…