CMS Posts Final Medicare DMEPOS Fee Schedule Rate for the MyoPro®

Rhea-AI Summary

Myomo, Inc. (MYO) announces final Medicare DMEPOS fee schedule rates for MyoPro devices, effective April 1, 2024. The average rates for HCPCS codes L8701 and L8702 are $33,480.90 and $65,871.74 respectively. MyoPro officially classified in brace benefit category for lump sum reimbursement.

Insights

Medical Device Analyst

The finalization of Medicare DMEPOS fee schedule rates for Myomo's MyoPro devices marks a significant development for the company and its stakeholders. The set fees of $33,480.90 for the L8701 and $65,871.74 for the L8702 codes ensure a predictable reimbursement pathway for healthcare providers and patients utilizing these advanced medical robotic arms. This development could potentially lead to an increase in the adoption rates of MyoPro devices, as the financial uncertainty surrounding their coverage has been mitigated. From an investor's perspective, this news could translate into increased revenue projections for Myomo, particularly as the aging population grows and the incidence of neurological disorders potentially rises.

Healthcare Economist

Medicare's acceptance of the MyoPro devices under the brace benefit category and the establishment of fee schedule rates are crucial in understanding the economic impact on the healthcare system. The lump sum reimbursement model may encourage cost-effective treatment plans and could influence the market dynamics for upper-limb orthotic devices. It is essential to monitor how this pricing will compare with long-term patient outcomes and the overall cost of care for individuals with muscular weakness or partial paralysis. As healthcare spending is a significant concern, the cost-benefit analysis of such technologies will be under scrutiny to ensure they contribute to the sustainability of the Medicare program.

Market Research Analyst

Myomo's successful negotiation with CMS represents a strategic win, as Medicare Part B covers a substantial portion of the U.S. population that could benefit from the MyoPro. The clear reimbursement structure may serve as a catalyst for market expansion, both domestically and potentially internationally, as other countries often look towards CMS decisions when considering their own healthcare policies. Analyzing the competitive landscape, Myomo's pricing and reimbursement clarity may provide a competitive edge over similar devices lacking such Medicare endorsement. It will be interesting to observe how competitors respond and if this will lead to a shift in market share within the wearable medical robotics sector.

Fees for codes L8701 and L8702 are effective as of April 1, 2024

BOSTON--(BUSINESS WIRE)-- Myomo, Inc. (NYSE American: MYO) (“Myomo” or the “Company”), a wearable medical robotics company that offers increased functionality for those suffering from neurological disorders and upper-limb paralysis, today announced that on February 29, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the final Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment rates for the MyoPro®.

The final average fee schedule rates for the two Healthcare Common Procedures System (HCPCS) codes describing the MyoPro, L8701, our Motion W device, and L8702, our Motion G device, are $33,480.90 and $65,871.74, respectively, and can be found here beginning on page 67. On January 1, 2024, the MyoPro was officially classified in the brace benefit category, which enables reimbursement on a lump sum basis. These final fees become effective on April 1, 2024.

“We’re extremely gratified to have reached a successful conclusion with CMS, a process that started in 2018 with the granting of the two HCPCS billing codes,” stated Paul R. Gudonis, Myomo’s Chairman and CEO. “This is an important milestone for qualified Medicare Part B beneficiaries with long-term muscular weakness or partial paralysis, and for Myomo as a company. We extend thanks to the personnel at CMS for their efforts and for appreciating the benefits that powered braces such as the MyoPro can provide to Medicare Part B beneficiaries. "

About Myomo

Myomo, Inc. is a wearable medical robotics company that offers improved arm and hand function for those suffering from neurological disorders and upper-limb paralysis. Myomo develops and markets the MyoPro product line. MyoPro is a powered upper-limb orthosis designed to support the arm and restore function to the weakened or paralyzed arms of certain patients suffering from CVA stroke, brachial plexus injury, traumatic brain or spinal cord injury, ALS or other neuromuscular disease or injury. It is currently the only marketed device in the U.S. that, sensing a patient’s own EMG signals through non-invasive sensors on the arm, can restore an individual’s ability to perform activities of daily living, including feeding themselves, carrying objects and doing household tasks. Many are able to return to work, live independently and reduce their cost of care. Myomo is headquartered in Boston, Massachusetts, with sales and clinical professionals across the U.S. and representatives internationally. For more information, please visit www.myomo.com.

View source version on businesswire.com: https://www.businesswire.com/news/home/20240301527787/en/

For Myomo:

ir@myomo.com



Investor Relations:

Kim Sutton Golodetz

LHA Investor Relations

kgolodetz@lhai.com

212-838-3777

Source: Myomo, Inc.

FAQ

What is the ticker symbol for Myomo, Inc.?

The ticker symbol for Myomo, Inc. is MYO.

What are the final average fee schedule rates for HCPCS code L8701?

The final average fee schedule rate for HCPCS code L8701 is $33,480.90.

When will the final fees for MyoPro devices become effective?

The final fees for MyoPro devices will become effective on April 1, 2024.

What category was MyoPro officially classified in?

MyoPro was officially classified in the brace benefit category for lump sum reimbursement.