ALPHARETTA, Ga., Nov. 11,
2024 /PRNewswire/ -- Avanos Medical, Inc. (NYSE:
AVNS) announced today that the Centers for Medicare and Medicaid
Services (CMS) has issued its final Medicare Hospital Outpatient
Prospective Payment System (OPPS) and Medicare Ambulatory Surgical
Center (ASC) Payment System rule for 2025. This rule, effective
Jan. 1, 2025, implements the
Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act that
mandates separate Medicare payment for qualifying non-opioid drugs
and devices.
The NOPAIN Act, passed as part of the Consolidated Appropriation
Act of 2023, aims to increase patient access to non-opioid drugs
and devices used to manage pain in Hospital Outpatient (HOPD) and
ASC settings by providing additional Medicare reimbursement for
qualifying non-opioid items.
In the final rule, CMS confirmed that both the Avanos ON-Q
elastomeric infusion pump and the Avanos ambIT disposable
electronic infusion pump non-opioid pain management delivery
systems meet qualifying requirements, marking a significant
milestone as both become eligible for separate payment for the
first time under the NOPAIN Act. HOPDs and ASCs that use these
products will receive separate Medicare reimbursement in addition
to the related APC payments beginning January 1, 2025.
Both ON-Q and ambIT infusion delivery systems each received a
unique, brand-specific Healthcare Common Procedure Coding System
(HCPCS) code eligible for separate payment in the HOPD and ASC
settings. This decision by CMS is a pivotal step towards enhancing
access to clinically proven non-opioid treatments for Medicare
beneficiaries in HOPD and ASC settings.
The payment limitation calculated and published by CMS is
up to $2,284.98 for the ON-Q infusion system and up
to $2,284.98 for the ambIT infusion system. The new unique
HCPCS code C9804 for ON-Q and HCPCS code C9806 for ambIT can be
used on claim submissions beginning for services rendered on
January 1, 2025.
The NOPAIN Act mandates that CMS provide separate payment for
qualified non-opioid treatments through December 31, 2027 when provided with a covered
surgical procedure. The ON-Q and ambIT devices are now the first
and only infusion pain pumps included under this policy, which aims
to reduce reliance on opioids in postoperative care. CMS will
review and approve eligible products on an annual basis during this
3-year program. This initiative is part of a broader strategy
by CMS to combat the opioid crisis by promoting safer pain
management alternatives.
Michael Greiner, Avanos Medical's
interim CEO, praised the CMS decision, stating, "The inclusion of
ON-Q and ambIT pumps under the NOPAIN Act is a testament to the
devices' effectiveness in reducing opioid use after surgery. We
commend CMS for their commitment to improving patient access to
non-opioid therapies, and we are dedicated to collaborating with
healthcare professionals to advocate for proven non-opioid
treatments."
The ON-Q elastomeric and ambIT electronic infusion pumps have
been validated by CMS as a treatment that can effectively replace
or reduce postoperative opioid use, as proven by clinical trials
and peer-reviewed data. These innovative devices continuously
deliver local anesthetic, providing patients with targeted pain
relief while minimizing opioid consumption.
For more information on ON-Q and ambIT coverage under the NOPAIN
Act, please click here: Avanos NOPAIN Act.
For inquiries regarding the NOPAIN Act, contact our Market
Access and Reimbursement Team at reimbursement@avanos.com.
To view the final rule in its entirety, visit the Federal
Register.
About Avanos Medical
Avanos Medical (NYSE: AVNS)
is a medical technology company focused on delivering clinically
superior medical device solutions that will help patients get back
to the things that matter. Headquartered in Alpharetta,
Georgia, Avanos is committed to
addressing some of today's most important healthcare needs,
including providing a vital lifeline for nutrition to patients from
hospital to home, and reducing the use of opioids while helping
patients move from surgery to recovery. Avanos develops,
manufactures and markets its recognized brands globally and holds
leading market positions in multiple product categories. For more
information, visit www.avanos.com and follow Avanos
Medical on X (@AvanosMedical), LinkedIn and Facebook.
*Registered Trademark or Trademark of Avanos Medical, Inc.,
or its affiliates. © 2018-2024 AVNS. All rights reserved.
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SOURCE Avanos Medical
