Helius Medical Technologies, Inc. Announces First Reimbursement by A Major Healthcare Provider for its Portable Neuromodulation Stimulator (PoNS®) Device
Helius Medical Technologies (HSDT) has achieved a significant milestone with its first reimbursement from a major healthcare provider for its Portable Neuromodulation Stimulator (PoNS®) Device. Anthem Blue Cross Blue Shield approved the claim at an out-of-network adjusted list price.
The reimbursement payment, including patient co-payment, amounted to $15,420 for the PoNS controller and mouthpiece. This out-of-network total lump sum payment, typically 30-40% below in-network contracted rates, establishes a important benchmark for future negotiations with major commercial insurance carriers.
The company views this development as validation of PoNS's therapeutic benefit and economic value for payers, particularly significant as Helius appeals current CMS payment rates.
Helius Medical Technologies (HSDT) ha raggiunto un traguardo significativo con il suo primo rimborso da un importante fornitore di assistenza sanitaria per il suo Dispositivo di Stimolazione Neuromodulativa Portatile (PoNS®). Anthem Blue Cross Blue Shield ha approvato la richiesta a un prezzo di listino rettificato per l'out-of-network.
Il pagamento del rimborso, inclusa la quota di partecipazione del paziente, ammontava a $15,420 per il controller PoNS e il bocchino. Questo pagamento totale forfettario per l'out-of-network, tipicamente dal 30% al 40% al di sotto delle tariffe contrattate in-network, stabilisce un importante punto di riferimento per future negoziazioni con i principali assicuratori commerciali.
L'azienda considera questo sviluppo come una convalida del beneficio terapeutico e del valore economico del PoNS per i pagatori, particolarmente significativo poiché Helius sta facendo appello alle attuali tariffe di pagamento CMS.
Helius Medical Technologies (HSDT) ha logrado un hito significativo con su primer reembolso de un importante proveedor de atención médica por su Dispositivo de Estimulación Neuromoduladora Portátil (PoNS®). Anthem Blue Cross Blue Shield aprobó la reclamación a un precio de lista ajustado fuera de red.
El pago del reembolso, incluyendo el copago del paciente, ascendió a $15,420 por el controlador PoNS y la boquilla. Este pago total único fuera de red, típicamente del 30% al 40% por debajo de las tarifas contratadas en red, establece un importante punto de referencia para futuras negociaciones con los principales aseguradores comerciales.
La empresa considera este desarrollo como una validación del beneficio terapéutico y del valor económico del PoNS para los pagadores, siendo particularmente significativo mientras Helius apela las tarifas de pago actuales de CMS.
Helius Medical Technologies (HSDT)는 휴대용 신경 조절 자극기 (PoNS®) 장치에 대해 주요 의료 제공자로부터 첫 번째 환급을 받으며 중요한 이정표를 세웠습니다. Anthem Blue Cross Blue Shield는 네트워크 외 조정 가격으로 청구를 승인했습니다.
환급 금액은 환자의 공동 부담금을 포함하여 PoNS 컨트롤러와 마우스피스에 대해 $15,420에 달했습니다. 이 네트워크 외 총 일시불 지급은 일반적으로 네트워크 내 계약 요금보다 30-40% 낮은 금액으로, 주요 상업 보험사와의 향후 협상에 중요한 기준을 설정합니다.
회사는 이 발전을 PoNS의 치료적 이점과 지불자에게 경제적 가치를 검증하는 것으로 간주하며, Helius가 현재 CMS 지급 요율에 항소하는 상황에서 특히 중요합니다.
Helius Medical Technologies (HSDT) a atteint une étape significative avec son premier remboursement d'un grand fournisseur de soins de santé pour son Dispositif de Stimulation Neuromodulatrice Portable (PoNS®). Anthem Blue Cross Blue Shield a approuvé la demande à un prix de liste ajusté hors réseau.
Le paiement de remboursement, y compris la participation du patient, s'élevait à $15,420 pour le contrôleur PoNS et l'embout buccal. Ce paiement total forfaitaire hors réseau, généralement 30 à 40 % en dessous des tarifs contractuels en réseau, établit une référence importante pour les futures négociations avec les principaux assureurs commerciaux.
L'entreprise considère ce développement comme une validation du bénéfice thérapeutique et de la valeur économique du PoNS pour les payeurs, ce qui est particulièrement significatif alors que Helius fait appel aux taux de paiement actuels de CMS.
Helius Medical Technologies (HSDT) hat einen bedeutenden Meilenstein erreicht, indem es von einem großen Gesundheitsdienstleister die erste Erstattung für sein Tragbares Neuromodulationsstimulationsgerät (PoNS®) erhalten hat. Anthem Blue Cross Blue Shield hat den Antrag zu einem angepassten Listenpreis außerhalb des Netzwerks genehmigt.
Die Erstattungszahlung, einschließlich der Zuzahlung des Patienten, betrug $15,420 für den PoNS-Controller und das Mundstück. Diese Gesamtsumme für die Erstattung außerhalb des Netzwerks liegt typischerweise 30-40% unter den vertraglichen Sätzen innerhalb des Netzwerks und setzt einen wichtigen Maßstab für zukünftige Verhandlungen mit großen gewerblichen Versicherern.
Das Unternehmen sieht diese Entwicklung als Bestätigung des therapeutischen Nutzens und des wirtschaftlichen Wertes von PoNS für die Kostenträger, was besonders wichtig ist, da Helius gegen die aktuellen CMS-Zahlungsraten Berufung einlegt.
- First reimbursement approval from a major healthcare provider (Anthem)
- Significant payment of $15,420 for device and mouthpiece
- Validation of product pricing and therapeutic value
- Potential for higher reimbursement rates with in-network contracts (30-40% higher)
- Currently to out-of-network coverage
- Ongoing appeals with CMS regarding payment rates
- Reimbursement amount is below potential in-network rates
--Anthem Blue Cross Blue Shield approves claim for PoNS Device at out-of-network adjusted list price--
--Provides further validation of PoNS pricing--
NEWTOWN, Pa., March 11, 2025 (GLOBE NEWSWIRE) -- Helius Medical Technologies, Inc. (Nasdaq:HSDT) (“Helius” or the “Company”), a neurotech company focused on delivering a novel therapeutic neuromodulation approach for balance and gait deficits, today announced its first reimbursement payment from a major healthcare provider, Anthem Blue Cross Blue Shield, for its PoNS Device.
“The first reimbursement from a commercial healthcare provider is a significant achievement for Helius and MS patients. The payment at out-of-network adjusted list price further validates the therapeutic benefit of PoNS and its economic value for payers,” said Dane Andreeff, Helius President and Chief Executive Officer. “This is an important milestone in the pursuit of third-party reimbursement and coverage and as we appeal the current CMS payment rates. We will remain steadfast in prioritizing increased patient access to support more MS patients and drive growth of the business.”
“Importantly, this was an out-of-network total lump sum reimbursement payment, which typically is 30 to
About Helius Medical Technologies, Inc.
Helius Medical Technologies is a leading neurotech company in the medical device field focused on neurologic deficits using orally applied technology platform that amplifies the brain’s ability to engage physiologic compensatory mechanisms and promote neuroplasticity, improving the lives of people dealing with neurologic diseases. The Company’s first commercial product is the Portable Neuromodulation Stimulator. For more information about the PoNS or Helius Medical Technologies, visit www.heliusmedical.com.
About the PoNS Device and PoNS Therapy
The Portable Neuromodulation Stimulator (“PoNS”) is an innovative, non-implantable, orally applied therapy that delivers neurostimulation through a mouthpiece connected to a controller while it’s used, primarily at home, with physical rehabilitation exercise, to improve balance and gait. The PoNS device, which delivers mild electrical impulses to the tongue, is indicated for use in the United States as a short-term treatment of gait deficit due to mild-to-moderate symptoms from multiple sclerosis (“MS”) and is to be used as an adjunct to a supervised therapeutic exercise program in patients 22 years of age and over by prescription only.
PoNS has shown effectiveness in treating gait or balance and a significant reduction in the risk of falling in stroke patients in Canada, where it received authorization for sale in three indications: (i) for use as a short-term treatment (14 weeks) of gait deficit due to mild and moderate symptoms from stroke and is to be used in conjunction with physical therapy; (ii) for use as a short-term treatment (14 weeks) of chronic balance deficit due to mild-to-moderate traumatic brain injury (“mmTBI”) and is to be used in conjunction with physical therapy; and (iii) for use as a short-term treatment (14 weeks) of gait deficit due to mild and moderate symptoms from MS and is to be used in conjunction with physical therapy. PoNS is also authorized for sale in Australia for short term use by healthcare professionals as an adjunct to a therapeutic exercise program to improve balance and gait. For more information visit www.ponstherapy.com.
Cautionary Disclaimer Statement
Certain statements in this news release are not based on historical facts and constitute forward-looking statements or forward-looking information within the meaning of the U.S. Private Securities Litigation Reform Act of 1995 and Canadian securities laws. All statements other than statements of historical fact included in this news release are forward-looking statements that involve risks and uncertainties. Forward-looking statements are often identified by terms such as “believe,” “expect,” “continue,” “will,” “goal,” “aim” and similar expressions. Such forward-looking statements include, among others, statements regarding the appeal of CMS payment rates; the pursuit of third party reimbursement and coverage; .
There can be no assurance that such statements will prove to be accurate and actual results and future events could differ materially from those expressed or implied by such statements. Important factors that could cause actual results to differ materially from the Company’s expectations include uncertainties associated with the Company’s capital requirements to achieve its business objectives, availability of funds, the Company’s ability to find additional sources of funding, manufacturing, labor shortage and supply chain risks, including risks related to manufacturing delays, the Company’s ability to obtain national Medicare insurance coverage and to obtain a reimbursement code, the Company’s ability to continue to build internal commercial infrastructure, secure state distribution licenses, market awareness of the PoNS device, future clinical trials and the clinical development process, the product development process and the FDA regulatory submission review and approval process, other development activities, ongoing government regulation, and other risks detailed from time to time in the “Risk Factors” section of the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, and its other filings with the United States Securities and Exchange Commission and the Canadian securities regulators, which can be obtained from either at www.sec.gov or www.sedar.com.
The reader is cautioned not to place undue reliance on any forward-looking statement. The forward-looking statements contained in this news release are made as of the date of this news release and the Company assumes no obligation to update any forward-looking statement or to update the reasons why actual results could differ from such statements except to the extent required by law.
Investor Relations Contact
Philip Trip Taylor
Gilmartin Group
investorrelations@heliusmedical.com
FAQ
How much did Anthem Blue Cross Blue Shield reimburse for the HSDT PoNS Device?
What is the significance of HSDT's first insurance reimbursement for the PoNS Device?
How does the out-of-network reimbursement compare to potential in-network rates for HSDT's PoNS?
What medical condition is the HSDT PoNS Device designed to treat?
