Medtech


May 5, 2026

Inspire Medical & Messy Medicare Modifiers

By John Leppard

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…

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April 23, 2026

RAPID Device Coverage: Rebrand or Brand New?

By John Leppard

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…

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April 21, 2026

INSP: MAC Modifier Feedback Bolsters View

By John Leppard

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…

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April 9, 2026

Inspire Medical (INSP): More MAC Wrinkles

By John Leppard

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…

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April 9, 2026

iRhythm (IRTC): Medicare Coverage Risks

By John Leppard

We estimate that iRhythm (IRTC) faces a 1%-2% growth headwind from a finalized local coverage determination (LCD) on ambulatory cardiac monitoring (ACM), likely to be released in the coming weeks. While we expect the company’s…

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March 27, 2026

Quarterly Catalysts 2Q26: Medtech & Biopharma

By John Leppard

With government policy in a seemingly endless state of flux, we offer investors our quarterly lookahead to what we view as the most relevant catalysts across the medtech, biopharma, diagnostics, and life science tools (LST)…

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March 10, 2026

GKOS: Less Sanguine on iDose Coverage Questions

By John Leppard

Despite recent speculation that Medicare Administrative Contractors (MACs) may not pursue a formal coverage policy for GKOS iDose procedures, we continue to expect a draft local coverage determination (LCD) in Q2 / Q3. Following the…

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March 6, 2026

[INSP, LIVN, NYXH] New Hypoglossal Code By 2028

By John Leppard

As we had anticipated, the American Medical Association’s (AMA) CPT Editorial Panel will evaluate the creation of a new reimbursement code to describe single lead hypoglossal nerve neurostimulation (HGNS) devices (e.g., INSP’s Inspire V) at…

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February 26, 2026

INSP: Quick Thoughts on New Codes

By John Leppard

We see little practical reimbursement impact for INSP from CMS’s announcement this morning that it will be creating a set of new facility level C-codes for newer generation hypoglossal nerve stimulation (HGNS) device services (e.g.,…

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February 25, 2026

[EW, MDT, ABT] TAVR: Incremental Gains From Expected Coverage

By John Leppard

In advance of the CMS draft coverage decision for transcatheter aortic valve replacement (TAVR) due June 15 (final Sept. 15), we expect policy changes that – while positive – may be more incremental in their…

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