The Centers for Medicare & Medicaid Services (CMS) revised its April 2024 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies fee schedule to include a final lump-sum Medicare purchase fee schedule amount for personal exoskeletons, including the ReWalk Personal Exoskeleton. The final payment rate is effective for Medicare claims with dates of service on or after April 1.
The ceiling-to-floor range is $109,238-$81,929 and has an established rate of $91,032 for each state. CMS said that it calculated the final payment amount by averaging pricing information for exoskeleton devices from Lifeward, maker of the Rewalk, and other manufacturers.
“This CMS publication finalizes the payment rate for the ReWalk Personal Exoskeleton for 2024, which importantly concludes all open items related to establishing Medicare benefit category assignment, coding, and reimbursement,” said Larry Jasinski, CEO of Lifeward. “With this clarity, physicians can now prescribe the ReWalk Personal Exoskeleton with confidence that Medicare patients will have an established reimbursement pathway, allowing us to accelerate the process of providing our devices to the people who need them.”
The finalization of the payment level follows CMS’ previous determination through rulemaking that personal exoskeletons fall within the brace benefit category, which is reimbursed by Medicare on a lump-sum basis. The final payment determination was made by CMS through a “gap filling” process after CMS determined that lower-limb exoskeletons incorporate “revolutionary features” that cannot be described by any existing code or combination of codes.