Medtech


December 16, 2025

Skin Substitute Coverage: Pyrrhic Victory?

By John Leppard

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…

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December 16, 2025

EW, ABT, MDT: TAVR Coverage Coming

By John Leppard

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…

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December 12, 2025

INSP: Inspire V Coverage Questions Answered

By John Leppard

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…

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December 10, 2025

INSP / LIVN: Pricing, Payments & Policy

By John Leppard

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…

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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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