Inspire Medical Systems, Inc. Announces Approval of New Hypoglossal Nerve Stimulation CPT® Codes by the AMA Editorial Panel
Code approval covers Inspire V, while Medicare payment amounts still require a separate CMS valuation process.
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Rhea-AI Summary
Inspire Medical Systems (INSP) announced AMA Editorial Panel approval of new procedure codes covering its Inspire V nerve stimulation system. The Category I Current Procedural Terminology (CPT) codes are scheduled to take effect on January 1, 2028. They address implantation of a single lead and an implantable pulse generator.
Inspire expects the dedicated codes to reduce administrative burdens for hospitals and physicians and support greater patient access. The Centers for Medicare & Medicaid Services (CMS) will determine each code’s value, which sets Medicare payments for the service. Inspire expects proposed valuations in July 2027 and final valuations in November 2027.
How this balance works
Rhea-AI gives every point it takes from this document a weight. Minor counts 1, Moderate 3 and Major 9, so one Major point outweighs several Minor ones. The bar adds up the weights on each side, and when neither side holds more than 65% of the total the balance reads Mixed.
It reads the document as published, with the same rules for every company, and it does not look at what the market expected or at how the stock traded, so a point can be objectively good on a day the stock falls.
Rhea-AI Sentiment measures something else, the tone of the wording.
Hollow bars mark forward-looking points. How the balance works
Positive
- Moderate point. Forward-looking: it has not happened yet and may not happen.AMA approval establishes Category I CPT codes covering Inspire V, scheduled to take effect January 1, 2028.
- Minor point. Forward-looking: it has not happened yet and may not happen.Inspire expects dedicated codes to reduce administrative burden and support growth in patient access.
Negative
- Moderate point. Forward-looking: it has not happened yet and may not happen.Medicare payment valuations remain pending; Inspire expects proposed values in July 2027 and final values in November 2027.
Key Figures
- New CPT codes effective
- January 1, 2028
- Effective date for the new Category I codes
- Proposed valuation publication
- July 2027
- CMS valuation process for the new CPT codes
- Final valuation publication
- November 2027
- CMS valuation process for the new CPT codes
Key Terms
current procedural terminology regulatory
category i codes regulatory
implantable pulse generator medical
hypoglossal nerve stimulation medical
AI-generated analysis. How Rhea-AI works. Not financial advice.
MINNEAPOLIS, Oct. 01, 2026 (GLOBE NEWSWIRE) -- Inspire Medical Systems, Inc. (NYSE: INSP) (Inspire), a medical technology company focused on the development and commercialization of innovative, minimally invasive solutions for patients with obstructive sleep apnea (OSA), today announced that the American Medical Association (AMA) CPT® Editorial Panel has approved the establishment of a new set of Current Procedural Terminology (CPT®) codes that accurately describe and include the Inspire V system. The new Category I codes are scheduled to take effect on January 1, 2028.
“This new CPT code language addresses the implantation of a single lead and an implantable pulse generator (IPG) including our recently launched Inspire V system,” said Tim Herbert, Chairman and Chief Executive Officer of Inspire Medical Systems. “We appreciate the AMA creating dedicated codes that will create a clearer, more consistent path for coding and reimbursement, which we expect will reduce administrative burden for hospitals and physicians and support continued growth in patient access to Inspire therapy. The application received broad society support with special thanks to the American Academy of Otolaryngology-Head and the Neck Surgery (AAO-HNS), the American Academy of Sleep Medicine (AASM) and the International Surgical Sleep Society (ISSS) for their support addressing the need to act now to provide a permanent coding solution for the Inspire V system and other single lead hypoglossal nerve stimulation IPG therapies.”
With the new codes created, the Centers for Medicare & Medicaid Services (CMS) will conduct its standard process to determine the value for each new CPT code, which determines the payments for that service under Medicare. CMS typically requests the AMA Relative Value Scale Update Committee (RUC) to review specific codes and evaluate whether physician time, work and expenses for related services have changed over time.
Specialty societies, such as the AAO-HNS, may survey their members and make recommendations to the RUC based on the output from the rigorous methodology for these surveys. These surveys would collect information regarding physician work including both time and complexity, practice expenses including clinical staff and any required supplies and equipment, and liability insurance. Sufficient physicians are surveyed to ensure accuracy of data collected.
After collecting and reviewing the data, the RUC recommendation is provided to CMS who we expect would publish their proposed valuation in July 2027 with final valuations published in November 2027.
The new Category I CPT codes reflect a growing body of clinical evidence supporting therapies like Inspire’s closed-loop implantable device, Inspire V, which is designed to work with a patient’s natural breathing to help keep the airway open during sleep. With more than 140,000 patients treated and over a decade of clinical experience, Inspire is a well-established leader in the treatment of OSA.
About Inspire Medical Systems
Inspire Medical Systems is a medical technology company focused on the development and commercialization of innovative, minimally invasive solutions for patients with obstructive sleep apnea. Inspire’s proprietary Inspire therapy is the first FDA, EU MDR, and PDMA-approved neurostimulation technology that provides safe and effective treatment for moderate to severe obstructive sleep apnea.
For additional information about Inspire, please visit www.inspiresleep.com.
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical fact are forward-looking statements, including statements regarding the anticipated implementation and effective date of the newly approved CPT® codes and the potential impact of such codes on coding, reimbursement, patient access, and adoption of Inspire therapy. Forward-looking statements may be identified by words such as "anticipate," "believe," "expect," "intend," "may," "plan," "potential," "will," and similar expressions.
These forward-looking statements are based on management's current expectations and involve risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Additional information regarding these risks and uncertainties can be found under the caption "Risk Factors" in Inspire Medical Systems, Inc.'s most recent Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission.
Any forward-looking statements contained in this press release speak only as of the date hereof. Inspire undertakes no obligation to update any forward-looking statements, except as required by applicable law.
Investor Contact
Brian Johnston or Louisa Smith
Gilmartin Group, LLC
FAQ
AI-generated questions and answers. How Rhea-AI works. Not financial advice.
When do the new CPT codes covering Inspire V take effect?
The new Category I CPT codes covering Inspire V are scheduled to take effect on January 1, 2028. They address implantation of a single lead and an implantable pulse generator.
When will Medicare payment valuations for Inspire’s new CPT codes be published?
Inspire expects CMS to publish proposed valuations in July 2027 and final valuations in November 2027. CMS determines each new code’s value, which determines Medicare payments for the corresponding service.
How will physician surveys inform Medicare valuations for Inspire’s new CPT codes?
Specialty societies may survey physicians about work, practice expenses and liability insurance to inform recommendations to the AMA Relative Value Scale Update Committee. Physician work includes time and complexity; practice expenses include clinical staff, supplies and equipment. The committee reviews the data and provides its recommendation to CMS.