The Centers for Medicare & Medicaid Service (CMS) has approved significantly larger payment rates for the StimRouter Neuromodulation System (Bioness) in the Hospital Outpatient Prospective Payment System (HOPPS), under Current Procedural Terminology (CPT) code, 64555, for percutaneous implantation of a neurostimulator electrode array.
Effective 1 January, 2018, providers will receive increased payments from Medicare for the StimRouter implant procedure.
StimRouter is a minimally-invasive implanted device that is clinically proven to reduce pain by delivering gentle electrical pulses to stimulate the affected peripheral nerve which essentially “blocks” pain signals before they reach the brain. It is a cost-effective, long-term use alternative to prescribed opioids, injections, and mobility therapies.
“Many patients suffering from chronic pain are looking for effective alternatives to prescription medications and other traditional therapies which typically only offer short term solutions to the long-term problem of debilitating chronic pain,” says Todd Cushman, president and CEO of Bioness. “With the new payment ruling from CMS, we expect StimRouter will become widely available, allowing more patients to benefit from extended pain relief using our physician-implanted device with wireless controller that allows individuals to assume control over their pain.”
Under the new HOPPS rule, the payment rate for CPT code 64555 will increase by 11% when the StimRouter implantation procedure is performed in an outpatient hospital and 3% when the procedure is performed in an ambulatory surgery centre. Additionally, CMS’s 2018 Medicare Physician Fee Schedule (MPFS) increases reimbursement by 124% when the StimRouter implant procedure is performed in a physician’s office.
StimRouter is the first FDA-cleared neuromodulation device indicated to treat chronic pain of peripheral nerve origin. The medical device is being implanted at clinical institutions across the USA.