iRhythm® Technologies Comments on the Final Medicare Physician Fee Schedule Released by the Centers for Medicare and Medicaid Services for Calendar Year 2023
November 02 2022 - 5:45PM
iRhythm Technologies, Inc. (NASDAQ:IRTC), a leading digital health
care company focused on creating trusted solutions that detect,
prevent, and predict disease, today provided commentary on the
recently released Centers for Medicare and Medicaid Services
(“CMS”) Medicare Physician Fee Schedule (“MPFS”) Final Rule for
Calendar Year 2023 and accompanying addenda (the “Final Rule”). The
Final Rule was released on November 2, 2022 and updated payment
policies, payment rates and other provisions for services furnished
on or after January 1, 2023, which include those rates related to
long term electrocardiogram (“ECG”) monitoring and recording that
iRhythm uses to seek reimbursement for its Zio® XT service.
In the Final Rule, CMS established relative value units for
Current Procedural Terminology (“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) as well as a calendar
year 2023 Conversion Factor that, collectively with the Medicare
payment reduction (sequestration) and the sequestration under the
statutory Pay-As-You-Go, we believe reflect national reimbursement
rates of $224 and $213 for CPT codes 93247 and 93243, respectively.
Based on the calendar year 2023 Geographic Practice Cost Index
modifiers in the Final Rule that are applicable to the locations of
the Company’s Medicare-enrolled Independent Diagnostic Testing
Facilities (“IDTFs”) in San Francisco, CA, Deerfield, IL and
Houston, TX, iRhythm estimates the applicable reimbursement rates
could range from $227 to $307 for CPT code 93247 and $216 to $292
for CPT code 93243. Using the Final Rule’s implied rates and based
on the Company’s current expectations for volume mix in calendar
year 2023 across its IDTF locations, iRhythm estimates that, if the
calendar year 2023 reimbursement rates had been implemented in
2022, the impact to the Company’s revenue would have been
immaterial to its current fiscal year 2022 revenue guidance.
“Securing national pricing for long-term ECG monitoring is a
significant milestone for iRhythm and for the industry and brings
stability to our core U.S. business as well as improved access for
the patients we serve. We are appreciative of CMS’ continued
efforts to get to this important milestone,” said Quentin
Blackford, iRhythm’s President and CEO. “We believe CMS’ Final Rule
reflects support for the use of innovative diagnostic technology
for Medicare beneficiaries across the United States, though we
continue to believe that these rates may not fully value the
clinical benefits of AI used to deliver the Zio XT service. iRhythm
intends to continue partnering with CMS and other industry
stakeholders to advocate for national rates that reflect the full
value of extended Holter monitoring to drive appropriate access and
the availability of quality healthcare services for the benefit of
our patients.”
About iRhythm Technologies, Inc. iRhythm is a
leading digital health care company that creates trusted solutions
that detect, predict, and prevent disease. Combining wearable
biosensors and cloud-based data analytics with powerful proprietary
algorithms, iRhythm distills data from millions of heartbeats into
clinically actionable information. Through a relentless focus on
patient care, iRhythm’s vision is to deliver better data, better
insights, and better health for all.
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 those relating to the
Medicare reimbursement rates for the CPT codes primarily relied
upon for the Company’s Zio XT services and current expectations on
the volume mix 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 June
30, 2022, as filed with the Securities and Exchange Commission on
August 5, 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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