Medicare Revises 2024 Fee Schedule to Include Payment Rate for the ReWalk Personal Exoskeleton
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Insights
The finalized Medicare reimbursement for personal exoskeletons represents a significant development in the intersection of healthcare policy and medical technology. The inclusion of a specific reimbursement rate under the DMEPOS Fee Schedule provides a clear financial framework for the distribution and adoption of these devices. This decision by CMS acknowledges the therapeutic benefits and necessity of exoskeleton technology for individuals with mobility impairments.
From a policy standpoint, the 'gap filling' process used to determine the reimbursement rate indicates that CMS recognizes the innovative nature of exoskeletons and their lack of comparability to existing medical devices. The established rate of $91,032 sets a precedent for the valuation of similar future technologies. This move could potentially lead to increased research and development within the field, as manufacturers perceive a viable reimbursement pathway for cutting-edge medical devices.
However, the impact on the overall Medicare budget and implications for premiums and deductibles for beneficiaries must be considered. While this policy enhances access to advanced medical technology, it also adds to the growing cost of Medicare, which could have long-term sustainability implications for the program.
The CMS decision to set a reimbursement rate for personal exoskeletons is a pivotal moment for companies like Lifeward operating in the medical device sector. It effectively expands the market for these devices by enabling access to a broader patient population. For Lifeward, this development could lead to increased sales volumes, as physicians are more likely to prescribe devices with an established Medicare reimbursement pathway.
By setting a price range with a ceiling of $109,238 and a floor of $81,929, CMS is also indirectly influencing the pricing strategies of exoskeleton manufacturers. Companies will need to consider this range when setting the commercial prices for their devices to ensure they are competitive within the Medicare framework.
It is important to monitor the response from private insurers, as they often take cues from CMS decisions. If private insurers follow suit, the potential market for personal exoskeletons could grow significantly, impacting the stock performance of companies like Lifeward. Conversely, if insurers set lower reimbursement rates or impose stricter eligibility criteria, the market expansion could be less than expected.
The Medicare reimbursement for personal exoskeletons is likely to have a transformative effect on patient care within the realm of physical rehabilitation. Exoskeletons offer a novel approach to mobility assistance, providing a means for individuals with severe walking impairments to engage in ambulation activities. This can lead to improved health outcomes, such as enhanced cardiovascular health, reduced risk of secondary complications and improved quality of life.
However, the adoption of this technology in clinical practice will require training for healthcare providers and adjustments in rehabilitation protocols. The long-term benefits and potential risks of widespread use of exoskeletons in the Medicare population will need to be closely studied. As a new treatment modality, it is essential to ensure that the devices are used appropriately and that they deliver on the promise of improved patient outcomes without introducing new health risks.
Finalized Medicare reimbursement pathway for personal exoskeletons expands access for all eligible Medicare beneficiaries
MARLBOROUGH, Mass. and YOKNEAM ILLIT, Israel, April 12, 2024 (GLOBE NEWSWIRE) -- ReWalk Robotics Ltd. (DBA Lifeward™), (Nasdaq: LFWD) (“Lifeward” or the “Company”), a global market leader delivering life-changing solutions to revolutionize what is possible in rehabilitation, recovery, and the pursuit of life’s passions in the face of physical limitation or disability, today announced that the Centers for Medicare & Medicaid Services (“CMS”) has officially revised its April 2024 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Fee Schedule to include a final lump-sum Medicare purchase fee schedule amount for personal exoskeletons with a ceiling-to-floor range from
“This CMS publication finalizes the payment rate for the ReWalk Personal Exoskeleton for 2024, which importantly concludes all open items related to establishing Medicare benefit category assignment, coding, and reimbursement,” said Larry Jasinski, CEO of Lifeward. “With this clarity, physicians can now prescribe the ReWalk Personal Exoskeleton with confidence that Medicare patients will have an established reimbursement pathway, allowing us to accelerate the process of providing our devices to the people who need them.”
The finalization of the payment level follows the previous determination by CMS through rulemaking that personal exoskeletons such as the ReWalk Personal Exoskeleton fall within the brace benefit category, which is reimbursed by Medicare on a lump sum basis. The final payment determination was made by CMS through a “gap filling” process after CMS determined that lower extremity exoskeletons incorporate “revolutionary features” that cannot be described by any existing code or combination of codes. The final payment rate is in effective for Medicare claims with dates of service on or after April 1, 2024.
To learn more about Medicare reimbursement for Lifeward’s ReWalk Personal Exoskeleton, please visit GoLifeward.com/Medicare.
About Lifeward
Lifeward designs, develops, and commercializes life-changing solutions that span the continuum of care in physical rehabilitation and recovery, delivering proven functional and health benefits in clinical settings as well as in the home and community. Our mission at Lifeward is to relentlessly drive innovation to change the lives of individuals with physical limitations or disabilities. We are committed to delivering groundbreaking solutions that empower individuals to do what they love. The Lifeward portfolio features innovative products including the ReWalk Exoskeleton, the AlterG Anti-Gravity systems, the ReStore Exo-Suit, and the MyoCycle FES Systems.
Founded in 2001, Lifeward has operations in the United States, Israel, and Germany. For more information on the Lifeward product portfolio, please visit GoLifeward.com.
ReWalk®, ReStore® and Alter G® are registered trademarks of ReWalk Robotics Ltd. (DBA Lifeward) and/or its affiliates.
Forward-Looking Statements
In addition to historical information, this press release contains forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995, Section 27A of the U.S. Securities Act of 1933, as amended, and Section 21E of the U.S. Securities Exchange Act of 1934, as amended. Such forward-looking statements may include projections regarding the Company’s future performance and other statements that are not statements of historical fact and, in some cases, may be identified by words like "anticipate," "assume," "believe," "continue," "could," "estimate," "expect," "intend," "may," "plan," "potential," "predict," "project," "future," "will," "should," "would," "seek," and similar terms or phrases. The forward-looking statements contained in this press release are based on management's current expectations, which are subject to uncertainty, risks and changes in circumstances that are difficult to predict and many of which are outside of Lifeward’s control. Important factors that could cause the Company’s actual results to differ materially from those indicated in the forward-looking statements are more fully discussed in the Company’s periodic filings with the Securities and Exchange Commission (“SEC”), including the risk factors described under the heading "Risk Factors" in the Company’s annual report on Form 10-K for the year ended December 31, 2023 filed with the SEC and other documents subsequently filed with or furnished to the SEC. Any forward-looking statement made in this press release speaks only as of the date hereof. Factors or events that could cause the Company’s actual results to differ from the statements contained herein may emerge from time to time, and it is not possible for the Company to predict all of them. Except as required by law, Lifeward undertakes no obligation to publicly update any forward-looking statements, whether as a result of new information, future developments or otherwise.
Lifeward Media Relations:
LifeSci Communications
E: media@golifeward.com
Lifeward Investor Contact:
Mike Lawless
Chief Financial Officer
Lifeward
E: ir@golifeward.com
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