HeraBEAT users could be in line for full refunds on the cost of the product
Medical technology company, HeraMED Limited (ASX:HMD) is pursuing verification around the potential for its HeraBEAT and HeraCARE solutions to be reimbursed under the US reimbursement code system.
Should this occur, under new CPT (Current Procedural Terminology) codes users of HeraMED’s HeraBEAT and HeraCARE solutions would receive a full refund for the cost of the product.
CPT codes are procedural codes used for reporting medical, diagnostic, and surgical services performed by healthcare providers. The American Medical Association (AMA) holds the copyright to CPT codes used nationwide in the US.
Six new codes were recently introduced to help physicians and other healthcare professionals report a range of digital health services, including in home monitoring and electronic patient visits.
This feeds into the global Patient Monitoring Devices Market, which will surpass US$27 billion by 2025, with the North America patient monitoring devices market share anticipated to witness more than 4% growth in forthcoming future.
HeraMED plans to pursue verification around the potential to be reimbursed through these recently introduced CPT codes.
“With the advance of new technologies for e-visits and health monitoring, many patients are realising the best access point for physician care is once again their home,” AMA President Patrice Harris, MD, MA, said in a recent press release.
As part of its US market entry, HeraMED will engage with medical professionals and other expert consultants to verify if its HeraBEAT and HeraCARE platform may be eligible for reimbursement through the current set of CPT codes.
The company will also monitor for the introduction of new codes, which are expected over the course of 2020.
If HeraMED’s solutions are eligible, this may potentially drive uptake with key medical organisations and insurance companies throughout the country.
100% refund to the end user
HeraMED will initially target the following codes, which if its solution use is accepted, will potentially result in a total of US$115 in reimbursement per month, or a full refund to the end user.
● CPT code 99453 - US$19.46 on a one-off basis for the set up and patient education of solutions.
● CPT code 99454 - US$64.15 on a monthly basis for use of remote monitoring services including supply of daily recording and alert transmission.
● CPT code 99547 - US$51.54 (non-facility) and US$32.44 (facility) on a monthly basis for remote treatment monitoring services for 20 minutes or more by a clinical professional or healthcare professional requiring interactive communication with a patient or caregiver.
The CPT code allocation is determined by a dedicated CPT committee and insurance companies and while HeraMED is confident of a positive outcome, timing and path to allocation will be in the hands of third party providers.
The following table indicates the cost of HeraMED’s products and therefore what users could expect to receive back in terms of refund.
Underlining the significance of this development in terms of recognising the growing need for remote patient monitoring, chief executive and co-founder David Groberman said, “These new codes represent the continued trend towards remote patient monitoring and will become imperative as hospitals and health systems look to extend their reach of care to the home and non-traditional settings.
“As healthcare providers look to further increase their collaborations with patients and other care providers, HeraMED becomes better positioned as an innovative technology provider and a potential early mover in digital pregnancy monitoring.
“The company will continue to leverage its partnerships in the USA to progress its market entry and drive solution uptake.”
Board and management will provide further guidance on HeraMED’s US market entry progresses across calendar year 2020.