In a recent announcement, the Centers for Medicare & Medicaid Services (CMS) outlined plans to introduce three new supply codes in the upcoming 2025 Physician Fee Schedule (PFS) Proposed Rule. The purpose of these new codes is to accurately describe the inFlow Voiding Prosthesis and ensure that physicians receive appropriate payment rates for related services. This development is welcomed by Vesiflo, the manufacturer of the inFlow™ voiding prosthesis, as it addresses inconsistencies in pricing that have been observed by Medicare Administrative Contractors (MACs) responsible for payment and coverage decisions.
Kevin Connolly, CEO of Vesiflo, expressed his support for CMS’ proposal, emphasizing the significance of the inFlow voiding prosthesis as an alternative to urinary catheters for women with certain neurologic conditions. He highlighted the challenges faced by prescribing physicians in securing proper payment for necessary supplies and commended CMS for taking steps to improve payment consistency through the creation of new supply codes specifically for the inFlow system.
The proposed supply codes include the inFlow Measuring Device (SD370) priced at $140, the inFlow Valve-Pump (SD371) priced at $495, and the inFlow Activator Kit (SD372) priced at $1,250. These codes, if approved, will be effective starting January 1, 2025, coinciding with Vesiflo’s national sales launch for the inFlow system. Jerry Stringham, President of Medical Technology Partners, echoed support for CMS’ initiative, emphasizing the need for MACs to establish appropriate payment rates that fully account for the components of the inFlow system.
Stakeholders and interested parties have until September 9, 2024, to provide feedback on the proposed rule. Vesiflo encourages individuals to visit their website for more information on the inFlow voiding prosthesis. For further inquiries, Susan Robinson can be reached at 425-242-6373 or through the Vesiflo website.
Overall, CMS’ efforts to address payment inconsistencies and improve access to innovative medical technologies like the inFlow system are laudable. By creating new supply codes that accurately reflect the value of these products, CMS is paving the way for more equitable reimbursement practices across MACs. Stakeholders in the healthcare industry are encouraged to participate in the feedback process to ensure that the final ruling benefits both healthcare providers and patients in need of specialized treatments.
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