NeuroPace Announces Favorable Medicare Reimbursement Increases for RNS System Physician and Hospital Outpatient Services
--Physician Fee Schedule (PFS) final rule substantially increases reimbursement for RNS neurostimulator implantation and replacement procedures--
--CY 2026 Outpatient Prospective Payment System (OPPS) Final Rule moves RNS replacement procedures to highest-paying neurostimulator APC--
In the CY 2026 Medicare PFS final rule, the Centers for Medicare & Medicaid Services (CMS) significantly increased professional payment for neurosurgeons who implant and replace the RNS System. Payment rates increased by approximately
“We are encouraged by CMS’ decision to meaningfully increase physician payment for RNS neurostimulator implant and replacement procedures,” said Joel Becker, Chief Executive Officer of NeuroPace. “These changes better reflect the physician resources used in treating patients with RNS therapy and, over time, should further support neurosurgeon adoption and procedure growth.”
Separately, in the CY 2026 OPPS final rule, CMS has reassigned RNS System replacement procedures (CPT 61891) from APC 5464 (Level 4 Neurostimulator and Related Procedures) to APC 5465 (Level 5 Neurostimulator and Related Procedures), increasing the average hospital Medicare reimbursement for RNS System replacements by
“We appreciate CMS’ decision to reassign RNS System replacement procedures to the highest-paying APC level for neurostimulators, which is a better reflection of the hospital resources required for these cases,” Joel Becker continued. “As replacement procedures become an increasingly meaningful contributor to our business over time, this decision should provide a helpful tailwind while supporting sustained access for Medicare beneficiaries treated in the outpatient setting.”
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sschaper@neuropace.com
investors@neuropace.com
Source: NeuroPace, Inc.