Lifeward issued an open letter from CEO Larry Jasinski to company shareholders discussing its progress with the Centers for Medicare & Medicaid Services (CMS) in establishing a payment rate for ReWalk exoskeletons. On February 29, CMS deferred a final payment rate for a Healthcare Common Procedure Coding System (HCPCS) code so the agency could obtain more information about pricing of Lifeward’s latest generation exoskeleton.
As a result of the deferral, the payment rate is not included in CMS’ April 2024 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) fee schedule of Medicare payment rates.
“Since the HCPCS final determination was released, we have worked very closely with the agency to review the invoice and transaction information that we had previously submitted and provide supplemental data or explanations as additional questions arise,” Jasinski wrote in the letter.
“While the latest development is a temporary delay, we are encouraged that CMS has indicated to us that once it determines a final payment rate, the agency can amend the April 2024 DMEPOS fee schedule so that the payment rate for exoskeletons can be established for the rest of 2024. This is important because it means that the establishment of a payment rate does not need to be delayed until the next HCPCS cycle six months from now. Our active engagement with CMS is ongoing and we work to establish the payment rate as soon as possible.”
Until a payment rate is added to the DMEPOS schedule, the Medicare Administrative Contractors cand approve and pay claims on a case-by-case basis with discretion to set the payment rate.
