REDMOND, Wash., July 26, 2024 /PRNewswire/ — The Centers for Medicare & Medicaid Services (CMS), in its 2025 Physician Fee Schedule (PFS) Proposed Rule, announced its intent to create three new supply codes in its direct Practice Expense (PE) Database to describe the inFlow Voiding Prosthesis and facilitate appropriate payment rates for related physician services. Vesiflo appreciates CMS’ acknowledgment of inconsistencies in pricing for the relevant physician service codes by the Medicare Administrative Contractors (MACs) to whom decisions about payment and coverage have been delegated by CMS. Per CMS, the creation of the new supply codes should help the MACs to establish more consistency and appropriate inclusion of the inFlow in pricing for these services.
Kevin Connolly, CEO of Vesiflo, applauds CMS’ proposal, stating, “The inFlow voiding prosthesis is the only alternative to life-long use of urinary catheters for women with impaired bladder function due to life-altering neurologic conditions like MS, spinal cord injury, spina bifida and multiple system atrophy. It is frustrating for prescribing physicians to be responsible for purchasing supplies to treat these patients and then have to repeatedly challenge the MACs for appropriate payment. We are grateful to CMS for acknowledging the challenges that inconsistent and uncertain payment creates for patient access and for proposing to create new supply codes to facilitate the setting of consistent and appropriate payment rates that account for the device costs.”
The supply codes that CMS proposes to create describe the inFlow Measuring Device (SD370) with a proposed price of $140, the inFlow Valve-Pump (SD371) with a proposed price of $495, and the inFlow Activator Kit (SD372) with a proposed price of $1,250. If finalized, these codes would take effect on Jan. 1, 2025, at which time Vesiflo plans to initiate national sales.
Jerry Stringham, President of the reimbursement consulting firm Medical Technology Partners, added, “While some of the MACs have established appropriate payment, others have continued to underpay for inflow-related services. We welcome and fully support CMS’ statement in the 2025 proposed rule that the MACs should establish appropriate payment for inFlow and that the payment rate needs to incorporate the components of the inFlow system. This will simplify the process of establishing appropriate and consistent fee schedules for each of the MACs.”
Comments on the proposed rule are open until Sept. 9, 2024.
Vesiflo is the manufacturer of the inFlow™ voiding prosthesis used by women with permanent urinary retention. For more information, go to www.vesiflo.com.
Please contact: Susan Robinson, 380909@email4pr.com
Contact:
Susan Robinson
380909@email4pr.com
425-242-6373
SOURCE Vesiflo