iRhythm has been navigating through reimbursement turbulence since late January 2021, but updated rates posted Monday morning by Medicare Administrative Contractor (MAC) Novitas appear to be a positive sign for the company.
After initially slashing reimbursement rates for for CPT (current procedural terminology) codes that cover iRhythm Technologies' Zio Patch to about $43 from about $300 nearly a year ago, Novitas upped the rates in April to $103 and $115. iRhythm said at that time it would discontinue providing its Zio XT service (Zio Patch) to the Medicare fee-for-service segment if those rates remain unchanged. Then, in November, the Centers for Medicare and Medicaid Services (CMS) recommended a $200 price for the patch but chose not to finalize national pricing and instead maintained contractor pricing for the relevant CPT codes for 2022.
The newly posted rates are set at $222 and $232 are retroactive to Jan. 1, 2022. Had the new rates been in effect in 2021, it would have positively impacted the company's total 2021 revenue by about 10%, iRhythm noted.
The San Francisco, CA-based company's technology combines wearable biosensor devices worn for up to 14 days and cloud-based data analytics with algorithms that distill data from millions of heartbeats into clinically actionable information.