Medtech

Key Takeaways: The coordinated release of finalized skin substitute local coverage determinations (LCDs) from all seven Medicare Administrative Contractors (MACs) this morning is largely in keeping with our expectations, with Coloplast (COLOB.DC) seeing the greatest…

Key Takeaways: Following the split market reaction to EXAS [-29%] and GH [+25%] 3Q24 earnings reports last week, and investors looking to the opportunities associated with next generation colorectal cancer (CRC) screening tests Cologuard Plus…

Key Takeaways: Consistent with our pre- and post-rule expectations [here, here, here], CMS this weekend has updated the payment tables released with its CY25 hospital outpatient rule on Nov. 1, reducing the per unit rate…

We continue to believe that CMS is likely to issue a revised hospital outpatient payment rate for Lantheus’ (LNTH) Pylarify in the coming days / weeks that would reduce the Medicare per service rate by…

Key Takeaways: We appear to have run the table with our pre-rule expectations [here, here] following CMS’s release Friday of its CY25 hospital outpatient payment rule, which includes the following company-specific implications: MDT & Otsuka…

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),…