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News & Media

May 22, 2017
New Reimbursement Code for HIFU Ablation

EDAP-TMS
EDAP Announces CMS Approval of New Reimbursement Code for HIFU Ablation of the Prostate EDAP TMS announced today that the Centers for Medicare and Medicaid Services (CMS) have established a new billing code for HIFU ablation of prostate tissue. "We are elated by CMS's decision," said Marc Oczachowski, EDAP's Chief Executive Officer. "This is another key milestone in the acceptance and recognition of HIFU technology in the U.S. as reflected by CMS's celerity in addressing the dossier, establishing a c-code and assigning a competitive coverage level. It will provide a choice between recognized therapies based solely on clinical need and evidence. The C-code is a significant achievement and opens the door to broader coverage from different payers, including private and commercial payers. We will now transition our efforts toward expanding coverage and physician education to make our innovative technology available to all patients in the U.S."

HIFU ablation of prostate tissue procedures have been assigned C-code 9747 - ambulatory payment classification (APC) 5376; the code will take effect July 1st, 2017. C-codes are unique, temporary pricing codes initially established for the Hospital Outpatient Prospective Payment System (OPPS). The C-codes are used on Medicare OPPS claims, and may also be recognized on claims from other providers or by other payment systems. The code is applicable to all procedures performed by the Company's HIFU devices, including whole primary whole gland prostate ablation, partial prostate ablation or whole and partial salvage ablation.

Mr. Ozachowski added, "I would like to thank Jerry Stringham, president of the reimbursement strategy consulting firm Medical Technology Partners for all of his hard work. Jerry has been instrumental in directing our efforts towards reimbursement. We look forward to continuing to work with his experienced team while we pursue additional reimbursement for HIFU procedures."