November 13, 2025
GKOS: iDose Medicare Coverage Expectations
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…
November 3, 2025
[MDXG, CTEC.LN, COLOB.C] Skin Substitute Rates & Additional Risks
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…
November 3, 2025
PRCT: Nominal Rates vs Opportunity Costs
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,…
October 31, 2025
Merit Medical (MMSI): Net vs List Price in Pass-Through Payments
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…
October 29, 2025
[MDT, Otsuka] Renal Denervation: Broad Coverage, With New Guardrails
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 /…
October 27, 2025
GKOS: iDose Coverage Question Tea Leaves
The questions to be addressed at a November 12 Contractor Advisory Committee (CAC) on GKOS’s iDose bolster our expectations for real, but likely manageable, headwinds via an eventual local coverage determination (LCD), which we suspect…
October 23, 2025
GKOS: iDose Smoke or Fire?
We view the weakness in GKOS shares this week as somewhat overdone following the announcement that iDose will be the subject of a Nov. 12 Contractor Advisory Committee (CAC) meeting among five Medicare Administrative Contractors…
October 17, 2025
Medtech & Biopharma 4Q25 Issue Items
Even amid a government shutdown – and in some ways because of it – 4Q25 promises a large number of policy catalysts across the medtech, diagnostics, life science tools (LST), and biopharma landscapes, informing company…
October 15, 2025
Multi-Cancer / Colorectal Coverage & Payments
We remain cautiously optimistic that any eventual longer-term FY26 funding bill will include legislation allowing – but not requiring – Medicare coverage of multi-cancer early detection (MCED) screening [GH, EXAS, GRAL]. Larger firms may nevertheless…
October 9, 2025
CGMs & Insulin Pumps: Competitive Bidding Lookahead
Despite the nearly ubiquitous opposition of stakeholders, we think CMS will likely finalize its intention to include continuous glucose monitors (CGMs) [DXCM, ABT] in the next round of the Competitive Bidding Program (CBP), along with…