Medtech

Key Takeaways: Consistent with our pre-rule expectations [see here], hospital outpatient rates for LNTH’s Pylarify appear set for a ~45% YoY decline in CY25 following CMS’s final rule. While enactment of “separate payments” for all…

Key Takeaways: With CMS likely to release its final CY25 hospital outpatient payment rule by Friday (typically aftermarket) or early next week, we offer the following expectations for key product payment decisions, listed in market…

Key Takeaways: With CMS due to release its CY25 hospital outpatient rule ~Nov. 1, we expect it to finalize separate payments for diagnostic radiopharmaceuticals, though with slight odds to the impact being a ~45% reduction…

Key Takeaways: We suspect Inspire Medical’s (INSP) next-generation Inspire V implant procedure can secure Medicare coverage / reimbursement under the legacy product’s billing code [CPT 64582: $816], where the shorter procedure time should increase physicians’…

Key Takeaways: With FDA’s early approval of Exact Sciences’ (EXAS) Cologuard Plus last week coming on the heels of CMS’s preliminary rejection of EXAS’s requested 25% rate increase ($636) relative to the legacy product ($509),…

Key Takeaways: With FDA’s early approval of Exact Sciences’ (EXAS) Cologuard Plus last week coming on the heels of CMS’s preliminary rejection of EXAS’s requested 25% rate increase ($636) relative to the legacy product ($509),…

Key Takeaways: As investors look to model out sales of Edwards Lifesciences’ (EW) Evoque tricuspid valve replacement in advance of CMS’s draft National Coverage Determination (NCD), which is expected by ~Dec. 20 (final policy due…