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ReWalk Robotics, a provider of technologies that enable mobility and wellness in rehabilitation and daily life for those with neurological conditions, today announced that the Centers for Medicare and Medicaid Services (CMS) has included the company’s personal prosthetic exoskeleton system in the agenda for the upcoming Healthcare Common Procedure Coding System (HCPCS) meeting at the end of November, providing a preliminary payment determination of $94,617..
ReWalk机器人技术公司,为神经系统疾病患者提供康复和日常生活中的移动性和健康性,今天宣布,医疗保险和医疗补助服务中心(CMS)已将该公司的个人假肢外骨骼系统纳入11月底即将召开的医疗保健通用程序编码系统(HCPCS)会议的议程中,提供初步支付金额94617美元。。
The announcement comes only days after CMS finalized its Calendar Year 2024 Home Health Prospective Payment System Rule CMS-1780 which now formally includes exoskeletons in the Medicare brace benefit category. The rule, issued Nov. 1, will take effect on Jan. 1, 2024.
该公告仅在CMS最终确定其日历年2024年家庭健康预期支付系统规则CMS-1780之后几天,该规则现在正式包括Medicare支架福利类别中的外骨骼。该规则于11月1日发布,将于2024年1月1日生效。
CMS determined through rulemaking that personal exoskeletons such as ReWalk’s device fall within the brace benefit category, which is reimbursed by Medicare on a lump sum basis.
CMS通过规则确定ReWalk设备等个人外骨骼属于支架福利类别,由Medicare一次性报销。
Previously, purchasers of the device have received reimbursement in only certain cases. In 2015, the Veterans Association (VA) issued a national policy for the evaluation, training, and procurement of ReWalk personal exoskeleton systems for all qualifying veterans across the United States. The VA policy was the first national coverage policy in the US for qualifying individuals with spinal cord injury.
以前,该设备的购买者仅在某些情况下收到报销。2015年,退伍军人协会(VA)发布了一项针对美国所有合格退伍军人评估,培训和采购ReWalk个人外骨骼系统的国家政策。VA政策是美国第一个针对脊髓损伤患者的全国覆盖政策。
According to a Form 10-K submitted by the company in 2015, in some cases, insurance companies provided reimbursement upon request, but other insurance companies categorized ReWalk as an experimental therapy and therefore did not provide coverage. Medicare and Medicaid also provided reimbursement for ReWalk rehabilitation sessions, but the coverage saw limits to frequency of treatment sessions.
根据公司在2015年提交的表格10-K,在某些情况下,保险公司根据要求提供报销,但其他保险公司将ReWalk归类为实验性治疗,因此没有提供保险。医疗保险和医疗补助也为ReWalk康复会议提供报销,但覆盖范围限制了治疗的频率。
Private insurance companies reimbursed on a case-by-case basis..
私营保险公司逐案报销。。
Then in July of 2020, ReWalk received CMS HCPCS level II code K1007 for its 6.0 exoskeleton system, which became effective on Oct. 1 of that year and marked the first such code for an exoskeleton medical device. Also in October, the company announced it had received authorization from CMS as a Medicare provider.
然后在2020年7月,ReWalk收到CMS HCPCS II级代码K1007,用于其6.0外骨骼系统,该系统于当年10月1日生效,并标志着外骨骼医疗器械的第一个此类代码。同样在10月,该公司宣布其已获得CMS作为Medicare提供商的授权。
The authorization means that ReWalk is able to bill Medicare directly for the procurement of its device for Medicare beneficiaries..
授权意味着ReWalk能够直接向Medicare开具账单,以便为Medicare受益人采购其设备。。
Now, the news of the CMS preliminary payment determination means the company will be able to provide access to a broader population of individuals. The payment determination was made through a “gap filling process applied in light of CMS determining that lower extremity exoskeletons incorporate ‘revolutionary features’ that cannot be described by any existing code of combination of codes,” according to a press release..
现在,CMS初步支付决定的消息意味着该公司将能够提供对更广泛人群的访问。根据新闻稿,付款的确定是通过“根据CMS确定下肢外骨骼具有“革命性特征”,而这些特征是任何现有的代码组合代码都无法描述的”。。
CMS uses verifiable supplier or commercial invoice pricing information and adjusts according to deflation and update factor methodology. When applying this formula to the code for the ReWalk device, CMS relied on average prices from 2020 market transactions, which were determined to be $125,500, resulting in the preliminary Medicare pricing of $94,617.
CMS使用可验证的供应商或商业发票定价信息,并根据通缩和更新因子方法进行调整。当将此公式应用于ReWalk设备的代码时,CMS依靠2020年市场交易的平均价格,确定为125500美元,导致Medicare初步定价为94617美元。
The service stated that it welcomes materials providing information on updated verifiable market transactions from the company as well as any other makers of similar products to “ensure that the Medicare payment amount for this code accurately reflects the full market of devices that would be classified in this code.”.
该服务表示,它欢迎材料提供有关公司以及任何其他类似产品制造商的最新可验证市场交易的信息,以“确保此代码的Medicare支付金额准确反映将在此分类的设备的完整市场代码“。
The final payment determination for ReWalk is expected in early 2024 with an April 1, 2024, effective date.
ReWalk的最终付款决定预计在2024年初,生效日期为2024年4月1日。
“The inclusion of the ReWalk Exoskeleton within the upcoming HCPCS agenda and the proposed preliminary pricing is a tremendous step forward in our efforts to ensure broader access to exoskeletons for the substantial percentage of the spinal cord injury community with Medicare coverage,” said Larry Jasinski, CEO of ReWalk, in the company press release.
“将ReWalk外骨骼纳入即将到来的HCPCS议程和拟议的初步定价是我们努力确保医疗保险覆盖范围内相当大比例的脊髓损伤社区更广泛地获得外骨骼的一大步,”公司新闻稿中ReWalk首席执行官Larry Jasinski说。
“ReWalk is encouraged by the process used by CMS to determine its preliminary pricing, and by the statements from CMS that they are open to receiving updated information on pricing that reflects the breakthrough technological developments, including technology that enables ambulation on stairs and curbs, which have been implemented since ReWalk’s 2020 application.
“ReWalk受到CMS用于确定其初步定价的过程以及CMS的声明的鼓励,他们可以随时获得反映突破性技术发展的定价更新信息,包括能够在楼梯和路边行走的技术,自ReWalk 2020年申请实施以来。
We look forward to continuing to work with CMS at the upcoming HCPCS meeting later this month.”.
我们期待本月晚些时候即将召开的HCPCS会议继续与CMS合作“。