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Comprehensive Strategy to Foster Innovation for Transformative Medical Technologies

Friday, May 17, 2019  
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On May 2, CMS Administrator Seema Verma for the first time walked through the agency’s comprehensive strategy to improve patients’ access to emerging technologies. The Administrator highlighted two specific actions.

First, for issuing HCPCS codes, CMS is changing the current process of allowing only one opportunity per year to apply for new Level II codes. The agency is moving to a process with quarterly opportunities to apply for drugs and semi-annual opportunities to apply for devices. CMS anticipates this will greatly improve the ability for technologies to move through the adoption curve.

Second, for technologies with CPT Category III codes (which are temporary codes used for emerging technologies), CMS is clarifying that for technologies that do not fall under an existing Local Coverage Determination (LCD), Medicare contractors are required to follow the transparent new LCD process for every local coverage decision, including reviewing the evidence with respect to the technology.

For More Information:

See the full text of this excerpted CMS Press Release (issued May 2).


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