iRhythm Technologies Comments on Centers for Medicare and Medicaid Services 2022 Medicare Physician Fee Schedule Final Rule
iRhythm Technologies (NASDAQ: IRTC) responded to the CMS 2022 Medicare Physician Fee Schedule, released on November 2, 2021. The Final Rule did not establish national pricing for relevant CPT codes associated with iRhythm’s Zio XT service, which is vital for extended ECG monitoring. The company is working with Medicare Administrative Contractors (MACs) to secure local pricing for these services. Although disappointed by the lack of national pricing, iRhythm remains hopeful about constructive discussions with MACs regarding appropriate rates.
- iRhythm is actively engaging with MACs to establish fair local rates for extended ECG monitoring services.
- CMS continues to work with industry stakeholders, which may benefit iRhythm in future discussions.
- The absence of national pricing in the 2022 physician fee schedule may hinder reimbursement stability for iRhythm's services.
- Uncertainty remains regarding the outcome and timing of iRhythm's negotiations with MACs.
SAN FRANCISCO, Nov. 02, 2021 (GLOBE NEWSWIRE) -- iRhythm Technologies, Inc. (NASDAQ: IRTC) (“iRhythm”), a leading digital healthcare solutions company focused on the advancement of cardiac care, today commented on the Centers for Medicare and Medicaid Services (CMS) Calendar Year 2022 Medicare Physician Fee Schedule (MPFS) Final Rule. The Final Rule and accompanying Addenda were released on November 2, 2021, along with updated payment policies, payment rates, and other provisions for services furnished under MPFS on or after January 1, 2022.
In the Final Rule, CMS did not issue national pricing and continued carrier pricing for calendar year 2022 on Category I CPT codes 93241, 93243, 93245 and 93247 for extended external ECG monitoring, the relevant codes for the Company’s Zio XT service.
iRhythm and other industry participants have been working with Medicare Administrative Contractors (MACs) to establish pricing for these codes. iRhythm remains engaged with all of the MACs and is working with other industry participants to submit additional cost data on long-term continuous ECG monitoring for consideration to establish fair and appropriate local rates. iRhythm is evaluating the new information included in the Final Rule and its potential implications on discussions with the MACs. iRhythm cannot provide certainty at this time on the potential outcome of the discussions with the MACs or on the timing of any action to be taken.
“While we are disappointed that national pricing was not included in the 2022 physician fee schedule, we are appreciative that CMS continues to engage with industry and other stakeholders to further their understanding of the cost components of AI-based solutions such as iRhythm’s Zio service. We firmly believe that national pricing remains the best option for all stakeholders,” said Quentin Blackford, iRhythm President and CEO. “In the meantime, we will continue to work with the MACs to provide information for the Calendar Year 2022 rate setting process and believe the Final Rule is potentially constructive in our conversations with the MACs. We will share updates at the appropriate time.”
iRhythm will provide further commentary, including remarks on this latest ruling by CMS, during its Third Quarter 2021 Earnings Call on Thursday, November 4, 2021 at 1:30 p.m. PT / 4:30 p.m. ET. Investors interested in listening to the conference call may do so by accessing the live and archived webcast of the event available on the “Investors” section of the company’s website at: www.irhythmtech.com.
About iRhythm Technologies, Inc.
iRhythm is a leading digital health care 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 clinical management of patients.
Forward-Looking Statements
This 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 reimbursement coverage and reimbursement rates. Such statements are based on current assumptions that involve risks and uncertainties that could cause actual outcomes and results to differ materially. These risks and uncertainties, many of which are beyond our control, include risks described in the section entitled “Risk Factors” and elsewhere in our filings made with the Securities and Exchange Commission on Forms 10-K and 10-Q. These forward-looking statements speak only as of the date hereof and should not be unduly relied upon. iRhythm disclaims any obligation to update these forward-looking statements.
Investor Relations Contact
Leigh Salvo
(415) 937-5404
investors@irhythmtech.com
Media Contact
Morgan Mathis
(310) 528-6306
irhythm@highwirepr.com
FAQ
What did iRhythm announce regarding Medicare pricing on November 2, 2021?
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