CVRx, a company focused on developing neuromodulation therapies, has secured a significant reimbursement win for its Barostim device. The Centers for Medicare and Medicaid Services (CMS) has assigned a new payment classification that substantially increases the reimbursement amount for the Barostim procedure, potentially broadening patient access to this innovative therapy for heart failure.
Barostim delivers targeted electrical pulses to baroreceptors located in the carotid artery wall. These pulses activate the body’s baroreflex, which in turn triggers an autonomic response that helps to restore balance to the autonomic nervous system and alleviate the symptoms of heart failure. The device has already received FDA breakthrough device designation and FDA approval for use in heart failure patients within the U.S.
Medicare Payment Updates
CMS has assigned Barostim to New Technology Ambulatory Payment Classification (APC) 1580. This APC payment ensures approximately $45,000 per procedure, and this rate is expected to continue into 2025, according to the published 2025 Medicare Hospital Outpatient Prospective Payment System (OPPS) final rule. This decision follows another recent reimbursement success where the American Medical Association CPT Editorial Panel approved the transition of Barostim from a Category III to Category I CPT code, with implementation expected on January 1, 2026.
Furthermore, CMS has reassigned Barostim to a higher-paying MS-DRG for inpatient procedures. Effective October 1, this change increased the payment to $43,000, a substantial rise from the previous range of $17,000 to $23,000.
Executive Perspective
Kevin Hykes, president and CEO of CVRx, expressed his appreciation for the CMS decision, stating, "We applaud this action by CMS, which appropriately recognizes the resource requirements associated with the Barostim implant procedure in the outpatient setting. We appreciate the support from the CMS Hospital Outpatient Physician Advisory Panel, medical societies, and the hospital and physician community throughout the public comment period."
Hykes further emphasized the positive impact of these reimbursement developments, noting, "The three positive reimbursement developments announced in the last month represent a fundamental and comprehensive improvement in physician coding and hospital reimbursement. This will facilitate broader patient access to Barostim therapy, further strengthening our commercial foundation."
