iRhythm® Technologies Comments on the Proposed Medicare Physician Fee Schedule Released by the Centers for Medicare and Medicaid Services for Calendar Year 2023
July 08 2022 - 08:30AM
GlobeNewswire Inc.
iRhythm Technologies, Inc. (NASDAQ:IRTC), a leading digital
healthcare solutions company focused on the advancement of cardiac
care, today provided comment on the recently released Centers for
Medicare and Medicaid Services (“CMS”) Medicare Physician Fee
Schedule Proposed Rule for Calendar Year 2023 (the “Proposed
Rule”). The Proposed Rule was released on July 7, 2022 and proposes
to update the payment rates and other provisions for services
furnished on or after January 1, 2023 and reimbursed under the
Medicare Physician Fee Schedule (“MPFS”). The Proposed Rule is
followed by a public comment period which will culminate with CMS’
release of a Final Rule, which is expected to be announced by early
November for implementation on January 1, 2023. The policies
announced in the Proposed Rule are therefore subject to change.
The Proposed Rule, with the accompanying addenda, include
proposed payment rates for two Category I Current Procedural
Terminology (“CPT”) code sets related to long term continuous
electrocardiogram (“ECG”) monitoring and recording that iRhythm
uses to seek reimbursement for its Zio® XT service. Category I CPT
codes 93241 through 93248 are split between two sets of four codes
with rates tied to those codes for (i) wear-time of greater than 48
hours and up to 7 days, and (ii) greater than 7 days up to 15 days.
iRhythm primarily relies on CPT codes 93247 (for wear-time of
greater than 7 days and up to 15 days) and 93243 (for wear-time of
greater than 48 hours and up to 7 days) to seek reimbursement for
its Zio XT service.
In the Proposed Rule, CMS proposed relative value units (“RVUs”)
for CPT codes 93247 and 93243 and a Calendar Year (“CY”) 2023
Conversion Factor that, collectively with the Medicare payment
reduction (sequestration) and the sequestration under the statutory
Pay-As-You-Go, may imply national payment rates of $215 and $204
for CPT codes 93247 and 93243 codes, respectively. Based on the
proposed CY 2023 Geographic Practice Cost Index (“GPCI”) modifiers
applicable to the locations of the Company’s Medicare-enrolled
Independent Diagnostic Testing Facilities (“IDTFs”) in Chicago, IL,
Houston, TX and San Francisco, CA, iRhythm estimates the applicable
payment rates could range from $218 to $295 for CPT code 93247 and
$207 to $280 for CPT code 93243. Using the Proposed Rule’s implied
rates and based on the Company’s current expectations for volume
mix across its IDTF locations in CY 2023, iRhythm initially
estimated that if the proposed CY 2023 rates had been implemented
for CY 2022, the impact to its revenues would have been immaterial
to its current full-year 2022 revenue guidance.
“We appreciate CMS’s evaluation of the cost inputs they have
been provided and for their continued focus on establishing
National rates for long-term continuous ECG monitoring,” said
Quentin Blackford, iRhythm’s President and CEO. “We will continue
to engage with CMS during the open comment period to share relevant
information in support of the rule-making process, in anticipation
of the release of the Final Rule. Meanwhile, we remain focused on
continuing the important work of delivering our Zio XT service to
the millions of patients who need it.”
About iRhythm Technologies, Inc. iRhythm is a
leading digital healthcare company redefining the way cardiac
arrhythmias are clinically diagnosed. The company combines wearable
biosensor devices worn for up to 14 days and cloud-based data
analytics with powerful proprietary algorithms that distill data
from millions of heartbeats into clinically actionable information.
The company believes improvements in arrhythmia detection and
characterization have the potential to change the clinical
management of patients.
Forward-Looking StatementsThis news release
contains forward-looking statements within the meaning of Section
27A of the Securities Act of 1933 and Section 21E of the Securities
Exchange Act of 1934 and the Private Securities Litigation Reform
Act of 1995. These statements include statements relating to the
potential Medicare reimbursement rates for the CPT codes primarily
relied upon for the Company’s Zio XT services, and current
expectations on the volume of services that may be performed at its
IDTF locations in calendar year 2023. Such statements are based on
management’s current assumptions that involve risks and
uncertainties, and actual outcomes and results could differ
materially from those anticipated. The risks and uncertainties that
may cause actual results to differ materially from current
expectations, many of which are beyond our control, include risks
more fully described in iRhythm’s Quarterly Report on Form 10-Q for
the period ended March 31, 2022, as filed with the Securities and
Exchange Commission on May 6, 2022. These forward-looking
statements speak only as of the date hereof and should not be
unduly relied upon. Except as required by law, iRhythm assumes no
obligation to update any such forward-looking statement after the
date of this release.
Investor Relations Contact Stephanie Zhadkevich
(919) 452-5430 stephanie.zhadkevich@irhythmtech.com
iRhythm Media Contact Morgan Mathis (310)
528-6306 irhythm@highwirepr.com
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