iRhythm Technologies Comments on the Centers for Medicare and Medicaid Services 2021 Proposed Medicare Physician Fee Schedule

SAN FRANCISCO, Aug. 04, 2020 (GLOBE NEWSWIRE) -- iRhythm Technologies, Inc. (NASDAQ: IRTC), a leading digital health care solutions company focused on the advancement of cardiac care, commented on the recently released Centers for Medicare and Medicaid Services (“CMS”) Calendar Year 2021 Medicare Physician Fee Schedule Proposed Rule (“the Proposed Rule”).  The Proposed Rule and accompanying Addenda were released on August 3, 2020 and August 4, 2020 and update payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (“PFS”) on or after January 1, 2021.  The Proposed Rule release is followed by a public comment period that will close on October 5, 2020 and will culminate in CMS' release of the Final Rule, which is expected to be announced on or around December 1, 2020 for implementation on January 1, 2021.  The Proposed Rule is therefore subject to change.

The Proposed Rule and accompanying Addenda include payment rates for two new Category I Current Procedural Terminology (“CPT”) code sets related to long term continuous electrocardiogram (“ECG”) monitoring and recording.  Category I CPT codes 93XX0 – 93XX7 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. 

iRhythm has analyzed the impact of the Proposed Rule and new codes on its business and has initially determined that if the new codes had been implemented as currently proposed, the impact to its revenues would be slightly positive based on full year 2019 Zio XT volume and wear-time mix. 

“We are pleased with the new code sets and the proposed rates in the Proposed Rule.  The new codes are validation of the clinical importance of long-term continuous monitoring and the proposed rates reflect the significant clinical value of our Zio XT service,” said Kevin King, iRhythm’s CEO.  “The proposed rates are in line with our expectations and we are looking forward to continuing the important work of delivering our Zio XT service to the millions of patients who need it.”