PROCEPT BioRobotics Announces New CPT® Category I Code from the American Medical Association for Aquablation therapy

Rhea-AI Summary

PROCEPT BioRobotics announced the American Medical Association (AMA) has granted a new CPT Category I code for its Aquablation therapy, used to treat benign prostatic hyperplasia (BPH). This decision, driven by increased usage and clinical success, will take effect on January 1, 2026, replacing the current Category III CPT code. Until then, the existing code, 0421T, remains in use. This advancement underscores Aquablation therapy's safety, efficacy, and acceptance in treating BPH.

Positive

• AMA granted a new CPT Category I code for Aquablation therapy, effective January 1, 2026.
• Increased utilization and strong clinical evidence supported the new CPT code.
• Recognition by AMA highlights safety and effectiveness of Aquablation therapy.
• Widespread adoption of Aquablation therapy acknowledged.

Negative

• The new CPT Category I code will not be effective until January 1, 2026, potentially delaying some financial benefits.
• Hospitals and physicians must continue using the existing Category III code (0421T) until the new code takes effect.

Insights

Medical Research Analyst

PROCEPT BioRobotics' new CPT Category I code for Aquablation therapy is a significant development in the medical field. The transition from a Category III to a Category I code indicates strong clinical evidence and increased utilization of the therapy. This is a positive signal to healthcare providers and insurers about the therapy's efficacy and safety. It suggests that Aquablation therapy has become a well-established procedure for treating benign prostatic hyperplasia (BPH), a common condition among older men.

Category I codes are generally more favorable for insurance reimbursement, which can lead to broader adoption of the therapy. This is a important factor for hospitals and physicians, as reimbursement rates can directly impact their decision to offer certain treatments. In the short term, the new code might not have an immediate effect, given that it will only be in place starting January 1, 2026. However, it sets the stage for potential growth in the long term as more hospitals may adopt Aquablation therapy.

Financial Analyst

For investors, this announcement has several implications. Firstly, the transition to a Category I code often results in increased procedure volumes due to better reimbursement rates, which can positively impact PROCEPT BioRobotics' revenues. Additionally, the acceptance of the new code underscores the clinical validation of their technology, potentially boosting investor confidence in the company's growth prospects.

On the financial side, investors should consider the long-term revenue potential from increased adoption of Aquablation therapy. While the new code takes effect in 2026, the anticipation of higher utilization rates could start reflecting in the company's stock price sooner, as market expectations adjust. This is particularly relevant for investors looking at PROCEPT BioRobotics from a growth investment perspective.

SAN JOSE, Calif., June 17, 2024 (GLOBE NEWSWIRE) -- PROCEPT BioRobotics^® Corporation (Nasdaq: PRCT) (the “Company”), a surgical robotics company focused on advancing patient care by developing transformative solutions in urology, announced today that the American Medical Association (“AMA”) has established a new Current Procedural Terminology (“CPT”) Category I code for transurethral waterjet resection of prostate tissue (“Aquablation therapy”) to treat benign prostatic hyperplasia (“BPH”).

In response to increased utilization of Aquablation therapy and strong evidence for its clinical outcomes, the AMA accepted PROCEPT BioRobotics’ application for a Category I CPT code, which will replace the existing Category III CPT code starting January 1, 2026. In the meantime, U.S. hospitals and physicians performing Aquablation therapy procedures should continue to utilize the existing Category III code, 0421T. 

“We are pleased that Aquablation therapy was approved by the AMA’s CPT^® Editorial Panel for Category I code status,” said Reza Zadno, CEO of PROCEPT BioRobotics. “The Category I code designation is a testament to the widespread adoption, safety and effectiveness of Aquablation therapy in treating BPH. We greatly appreciate the support and guidance the American Urological Association provided throughout this process.”

About Aquablation Therapy
Aquablation therapy is the first and only ultrasound guided, robotic-assisted, heat-free waterjet for the treatment of BPH. The system’s real-time ultrasound imaging provides the surgeon with a multi-dimensional view of the prostate enabling personalized treatment planning tailored to each patient’s unique anatomy. The surgeon can specify which areas of the prostate to remove while preserving the anatomy that controls erectile function, ejaculatory function and continence. Once the treatment plan is mapped by the surgeon, the predictable robotic-assisted execution enables prostate tissue to be removed in a precise, targeted, and controlled fashion.

About PROCEPT BioRobotics Corporation
PROCEPT BioRobotics is a surgical robotics company focused on advancing patient care by developing transformative solutions in urology. PROCEPT BioRobotics develops, manufactures and sells the AquaBeam Robotic System, an advanced, image-guided, surgical robotic system for use in minimally invasive urologic surgery with an initial focus on treating benign prostatic hyperplasia, or BPH. BPH is the most common prostate disease and impacts approximately 40 million men in the United States. PROCEPT BioRobotics designed Aquablation therapy to deliver effective, safe and durable outcomes for males suffering from lower urinary tract symptoms, or LUTS, due to BPH that are independent of prostate size and shape or surgeon experience. The Company has developed a significant and growing body of clinical evidence, which includes nine clinical studies and over 150 peer-reviewed publications, supporting the benefits and clinical advantages of Aquablation therapy.

Forward Looking Statements
This release contains forward‐looking statements within the meaning of federal securities laws, including with respect to the Company’s projected financial performance for full year 2024, statements regarding the potential utilities, values, benefits and advantages of Aquablation^® therapy performed using PROCEPT BioRobotics’ products, including AquaBeam^® Robotic System, which involve risks and uncertainties that could cause the actual results to differ materially from the anticipated results and expectations expressed in these forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements. Forward-looking statements are only predictions based on our current expectations, estimates, and assumptions, valid only as of the date they are made, and subject to risks and uncertainties, some of which we are not currently aware. Forward-looking statements may include statements regarding financial guidance, market opportunity and penetration, the Company’s possible or assumed future results of operations, including descriptions of the Company’s revenues, gross margin, profitability, operating expenses, installed base growth, commercial momentum, reimbursement coverage, overall business strategy, or information regarding the impact of other global events on the Company and its operations. Forward‐looking statements should not be read as a guarantee of future performance or results and may not necessarily be accurate indications of the times at, or by, which such performance or results will be achieved. These forward‐looking statements are based on the Company’s current expectations and inherently involve significant risks and uncertainties. Actual results and the timing of events could differ materially from those anticipated in such forward‐looking statements as a result of these risks and uncertainties. These risks and uncertainties are described more fully in the section titled “Risk Factors” in the Company’s filings with the Securities and Exchange Commission (the “SEC”), including the Company’s annual report on Form 10-K filed with the SEC on February 28, 2024. PROCEPT BioRobotics does not undertake any obligation to update forward‐looking statements and expressly disclaims any obligation or undertaking to release publicly any updates or revisions to any forward‐looking statements contained herein. These forward-looking statements should not be relied upon as representing PROCEPT BioRobotics’ views as of any date subsequent to the date of this press release.

Important Safety Information
All surgical treatments have inherent and associated side effects. For a list of potential side effects visit https://aquablation.com/safety-information/.

Investor Contact:
Matt Bacso
VP, Investor Relations and Business Operations
m.bacso@procept-biorobotics.com

FAQ

What is the new CPT code for Aquablation therapy by PROCEPT BioRobotics?

The American Medical Association has granted a new CPT Category I code for Aquablation therapy, effective January 1, 2026.

When will the new CPT Category I code for Aquablation therapy be effective?

The new CPT Category I code for Aquablation therapy will be effective from January 1, 2026.

Why was the new CPT code granted for Aquablation therapy?

The new CPT Category I code was granted due to increased utilization and strong clinical evidence supporting the safety and effectiveness of Aquablation therapy.

What is the current CPT code for Aquablation therapy by PROCEPT BioRobotics?

Until the new code takes effect, hospitals and physicians should continue using the existing Category III code, 0421T.

How does the new CPT Category I code for Aquablation therapy impact PROCEPT BioRobotics?

The new CPT Category I code signifies recognition of Aquablation therapy's safety, efficacy, and widespread adoption, potentially leading to broader acceptance and usage.