iRhythm issues comments on CMS 2021 MPFS Final Rule

iRhythm commented on the Centers for Medicare and Medicaid Services, or CMS, Calendar Year 2021 Medicare Physician Fee Schedule, or MPFS, Final Rule. The Final Rule was announced in a press release on December 1 and established payment policies, payment rates, and other provisions for services furnished under the MPFS on or after January 1, 2021. The company said, "The Final Rule describes two new Category I Current Procedural Terminology ("CPT") code sets related to long term continuous electrocardiogram ("ECG") monitoring and recording. Category I CPT codes 93241 - 93248 will replace Category III temporary CPT codes 0295T - 0298T as the primary codes that iRhythm uses to seek reimbursement for its Zio XT service. The eight new Category I CPT codes were split between two sets of four with rates tied to wear-time of greater than 48 hours and up to 7 days, and for greater than 7 days up to 15 days. These additional codes were established to define the associated time and work to monitor, detect and identify cardiac disease over longer periods of time which has been shown to lead to higher detection rates. At this time, the Company expects that the new CPT codes will be adopted by all U.S. payors for reporting purposes beginning January 1, 2021 when the new codes become effective. In the Final Rule, CMS did not finalize national pricing for the extended external ECG patch, medical magnetic tape recorder (SD339) supply, and ruled to contractor price CPT codes 93241, 93243, 93245 and 93247. iRhythm will be working with Medicare Administrative Contractors (MACs) to establish pricing for these codes."