Centers for Medicare & Medicaid Services Establishes New Category I CPT® Add-On Code for Coronary IVL
03 Novembre 2023 - 1:00PM
Shockwave Medical, Inc. (NASDAQ: SWAV), a pioneer in the
development and commercialization of transformational technologies
for the treatment of cardiovascular disease, announced today that
as part of the Calendar Year 2024 Physician Fee Schedule (PFS)
final rule, the U.S. Centers for Medicare & Medicaid Services
(CMS) has established a Category I Current Procedural Terminology
(CPT®) add-on code for procedures involving coronary Intravascular
Lithotripsy (IVL). These updates will become effective January 1,
2024.
The new CPT® code, +92972, has been created to describe when
coronary IVL is performed and has been assigned work Relative Value
Units (RVU) and professional fees that remunerate physicians for
the additional work associated with performing coronary IVL.
Because +92972 is an add-on code, the work RVUs and fees associated
with coronary IVL will be added to the remuneration physicians
receive for percutaneous coronary intervention (PCI) procedures,
including when atherectomy is also performed. The relevant code is
as follows:
CPT® |
Description |
Additional Work RVUs1 |
Additional Payment1,2 |
+92972 |
Percutaneous transluminal
coronary lithotripsy |
+2.97 |
+$140 |
- CMS-1784-F; Medicare Physician Fee
Schedule Fiscal Year 2024 Final Rule
- Payment rates do not take into
account geographical or additional adjustments. Providers should
contact their local Medicare Administrative Contractor (MAC) or CMS
for specific information as payment rates vary by region.
Prior to the establishment of CPT® code +92972, there were no
additional RVUs or fees for physicians who performed coronary IVL.
CMS first proposed the new CPT® add-on code via the FY2024 Proposed
PFS which, following a 60-day public comment period, has now been
finalized.
"We would like to thank the cardiology medical societies, the
American Medical Association CPT® Editorial Panel and staff and CMS
for their work in establishing a new CPT® code for coronary IVL.
Now that additional work RVUs and professional fees are associated
with coronary IVL, we believe physicians will be appropriately
remunerated for their commitment to adequate lesion preparation in
these complex interventions involving calcified coronary arteries,"
said Robert Fletcher, Senior Vice President of Marketing and Market
Access at Shockwave Medical.
CPT® is a registered trademark of the American Medical
Association. The coding, coverage, and payment information
contained herein is gathered from various resources and is subject
to change without notice. Shockwave Medical cannot guarantee
success in obtaining third-party insurance payments. Third-party
payment for medical products and services is affected by numerous
factors. It is always the provider’s responsibility to determine
and submit appropriate codes, charges, and modifiers for services
that are rendered. Providers should contact their third-party
payers for specific information on their coding, coverage, and
payment policies.
About Shockwave Medical, Inc.
Shockwave Medical is a leader in the development and
commercialization of innovative products that are transforming the
treatment of cardiovascular disease. Its first-of-its-kind
Intravascular Lithotripsy (IVL) technology has transformed the
treatment of atherosclerotic cardiovascular disease by safely using
sonic pressure waves to disrupt challenging calcified plaque,
resulting in significantly improved patient outcomes. Shockwave has
also recently acquired the Neovasc Reducer, which is under clinical
investigation in the United States and is CE Marked in the Europe.
By redistributing blood flow within the heart, the Reducer is
designed to provide relief to the millions of patients worldwide
suffering from refractory angina. Learn more
at www.shockwavemedical.com and www.neovasc.com.
Forward-Looking Statements
This press release contains statements relating to our
expectations, projections, beliefs, and prospects, which are
“forward-looking statements” within the meaning of the Private
Securities Litigation Reform Act of 1995. In some cases, you can
identify these statements by forward-looking words such as “may,”
“might,” “will,” “should,” “expects,” “plans,” “anticipates,”
“believes,” “estimates,” “predicts,” “potential” or “continue,” and
similar expressions, and the negative of these terms.
Forward-looking statements in this press release include, but are
not limited to, statements regarding our ability to obtain and
maintain reimbursement, and the amount thereof, for procedures
using our products. 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.
Important factors that could cause our actual results and
financial condition to differ materially from those indicated in
the forward-looking statements are discussed in our filings with
the Securities and Exchange Commission (SEC), including in the
sections titled “Risk Factors” in our most recent Annual Report on
Form 10-K and subsequently filed Quarterly Reports on Form 10-Q,
and in our other reports filed with the SEC. Except to the extent
required by law, we do not undertake to update any of these
forward-looking statements after the date hereof to conform these
statements to actual results or revised expectations.
Media Contact:Scott
Shadiow+1.317.432.9210sshadiow@shockwavemedical.com
Investor Contact:Debbie Kasterdkaster@shockwavemedical.com
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