RE:Apparently the codes have been approvedAbsolutely fantastic news, shediac! Not only that, the fee structure looks revenue generating. I like their accepted device price in establishing a starting point for determining coverage.
"To that end, we have identified and are using a commercial price of $1,19914 from an official distributor of Venowave in the United States.
As the price used in calculating the fee schedule amounts is greater than $150, payment would be made on a capped rental basis in accordance with our regulations at 42 CFR 414.229.
In accordance with regulations at 42 CFR 414.238(c), the 2024 price of $1,199 is deflated to the 1986 fee schedule base period using the percentage change in the consumer price index for all urban consumers (CPI-U) from the mid-point of the year the prices are in effect to the mid-point of the fee schedule base period. The price is then updated to the current year using the covered item update factors at section 1834(a)(14) of the Social Security Act.
Our preliminary determination is that the capped rental fee schedule amount would be approximately $78.05 on average for months 1 through 3, and approximately $78.05 on average for months 4 through 13, resulting in a total capped payment of $819.55 should there be 13 months of continuous use."