Helius Medical Technologies, Inc. Announces First Reimbursement by A Major Healthcare Provider for its Portable Neuromodulation Stimulator (PoNS®) Device

Rhea-AI Summary

Helius Medical Technologies (HSDT) has achieved a significant milestone with its first reimbursement from a major healthcare provider for its Portable Neuromodulation Stimulator (PoNS®) Device. Anthem Blue Cross Blue Shield approved the claim at an out-of-network adjusted list price.

The reimbursement payment, including patient co-payment, amounted to $15,420 for the PoNS controller and mouthpiece. This out-of-network total lump sum payment, typically 30-40% below in-network contracted rates, establishes a important benchmark for future negotiations with major commercial insurance carriers.

The company views this development as validation of PoNS's therapeutic benefit and economic value for payers, particularly significant as Helius appeals current CMS payment rates.

Positive

• First reimbursement approval from a major healthcare provider (Anthem)
• Significant payment of $15,420 for device and mouthpiece
• Validation of product pricing and therapeutic value
• Potential for higher reimbursement rates with in-network contracts (30-40% higher)

Negative

• Currently to out-of-network coverage
• Ongoing appeals with CMS regarding payment rates
• Reimbursement amount is below potential in-network rates

--Anthem Blue Cross Blue Shield approves claim for PoNS Device at out-of-network adjusted list price--

--Provides further validation of PoNS pricing--

NEWTOWN, Pa., March 11, 2025 (GLOBE NEWSWIRE) -- Helius Medical Technologies, Inc. (Nasdaq:HSDT) (“Helius” or the “Company”), a neurotech company focused on delivering a novel therapeutic neuromodulation approach for balance and gait deficits, today announced its first reimbursement payment from a major healthcare provider, Anthem Blue Cross Blue Shield, for its PoNS Device.  

“The first reimbursement from a commercial healthcare provider is a significant achievement for Helius and MS patients. The payment at out-of-network adjusted list price further validates the therapeutic benefit of PoNS and its economic value for payers,” said Dane Andreeff, Helius President and Chief Executive Officer. “This is an important milestone in the pursuit of third-party reimbursement and coverage and as we appeal the current CMS payment rates. We will remain steadfast in prioritizing increased patient access to support more MS patients and drive growth of the business.”

“Importantly, this was an out-of-network total lump sum reimbursement payment, which typically is 30 to 40% below in-network contracted payment rates. Therefore, we believe this reimbursement payment, including patient co-payment, of $15,420 for the PoNS controller and mouthpiece establishes an important benchmark as we approach major commercial insurance carriers to negotiate reimbursement payment rates for PoNS,” concluded Andreeff.

About Helius Medical Technologies, Inc. 

Helius Medical Technologies is a leading neurotech company in the medical device field focused on neurologic deficits using orally applied technology platform that amplifies the brain’s ability to engage physiologic compensatory mechanisms and promote neuroplasticity, improving the lives of people dealing with neurologic diseases. The Company’s first commercial product is the Portable Neuromodulation Stimulator. For more information about the PoNS or Helius Medical Technologies, visit www.heliusmedical.com.

About the PoNS Device and PoNS Therapy

The Portable Neuromodulation Stimulator (“PoNS”) is an innovative, non-implantable, orally applied therapy that delivers neurostimulation through a mouthpiece connected to a controller while it’s used, primarily at home, with physical rehabilitation exercise, to improve balance and gait. The PoNS device, which delivers mild electrical impulses to the tongue, is indicated for use in the United States as a short-term treatment of gait deficit due to mild-to-moderate symptoms from multiple sclerosis (“MS”) and is to be used as an adjunct to a supervised therapeutic exercise program in patients 22 years of age and over by prescription only.

PoNS has shown effectiveness in treating gait or balance and a significant reduction in the risk of falling in stroke patients in Canada, where it received authorization for sale in three indications: (i) for use as a short-term treatment (14 weeks) of gait deficit due to mild and moderate symptoms from stroke and is to be used in conjunction with physical therapy; (ii) for use as a short-term treatment (14 weeks) of chronic balance deficit due to mild-to-moderate traumatic brain injury (“mmTBI”) and is to be used in conjunction with physical therapy; and (iii) for use as a short-term treatment (14 weeks) of gait deficit due to mild and moderate symptoms from MS and is to be used in conjunction with physical therapy. PoNS is also authorized for sale in Australia for short term use by healthcare professionals as an adjunct to a therapeutic exercise program to improve balance and gait. For more information visit www.ponstherapy.com.

Cautionary Disclaimer Statement

Certain statements in this news release are not based on historical facts and constitute forward-looking statements or forward-looking information within the meaning of the U.S. Private Securities Litigation Reform Act of 1995 and Canadian securities laws. All statements other than statements of historical fact included in this news release are forward-looking statements that involve risks and uncertainties. Forward-looking statements are often identified by terms such as “believe,” “expect,” “continue,” “will,” “goal,” “aim” and similar expressions. Such forward-looking statements include, among others, statements regarding the appeal of CMS payment rates; the pursuit of third party reimbursement and coverage; .

There can be no assurance that such statements will prove to be accurate and actual results and future events could differ materially from those expressed or implied by such statements. Important factors that could cause actual results to differ materially from the Company’s expectations include uncertainties associated with the Company’s capital requirements to achieve its business objectives, availability of funds, the Company’s ability to find additional sources of funding, manufacturing, labor shortage and supply chain risks, including risks related to manufacturing delays, the Company’s ability to obtain national Medicare insurance coverage and to obtain a reimbursement code, the Company’s ability to continue to build internal commercial infrastructure, secure state distribution licenses, market awareness of the PoNS device, future clinical trials and the clinical development process, the product development process and the FDA regulatory submission review and approval process, other development activities, ongoing government regulation, and other risks detailed from time to time in the “Risk Factors” section of the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, and its other filings with the United States Securities and Exchange Commission and the Canadian securities regulators, which can be obtained from either at www.sec.gov or www.sedar.com.

The reader is cautioned not to place undue reliance on any forward-looking statement. The forward-looking statements contained in this news release are made as of the date of this news release and the Company assumes no obligation to update any forward-looking statement or to update the reasons why actual results could differ from such statements except to the extent required by law.

Investor Relations Contact 

Philip Trip Taylor
Gilmartin Group
investorrelations@heliusmedical.com

FAQ

How much did Anthem Blue Cross Blue Shield reimburse for the HSDT PoNS Device?

The total reimbursement payment, including patient co-payment, was $15,420 for the PoNS controller and mouthpiece.

What is the significance of HSDT's first insurance reimbursement for the PoNS Device?

It validates the device's therapeutic benefit and economic value, establishing a benchmark for future negotiations with major insurance carriers.

How does the out-of-network reimbursement compare to potential in-network rates for HSDT's PoNS?

The out-of-network payment is typically 30-40% below in-network contracted payment rates.

What medical condition is the HSDT PoNS Device designed to treat?

The PoNS Device treats balance and gait deficits in MS patients through therapeutic neuromodulation.