Published and Proposed Medicare Coverage through CGS and NGS MACs Will Reduce Number of Medication Trials, Leading to Increased Eligibility for TMS
MALVERN, Pa., Oct. 25, 2022 (GLOBE NEWSWIRE) — Neuronetics, Inc. (NASDAQ: STIM), a commercial stage medical technology company focused on designing, developing, and marketing products that improve the quality of life for patients who suffer from neurohealth disorders, announced healthcare policy updates that increase patient access to NeuroStar Advanced Therapy for Mental Health transcranial magnetic stimulation (TMS). The published and proposed updates will affect nearly 8 million covered lives.
CGS Medicare Administrative Contractor (MAC) has published an updated TMS coverage policy, effective December 4, 2022, that reduces the number of prior medication failures for TMS eligibility from four down to two for people suffering from major depressive disorder (MDD). The coverage policy update will affect 1.6 million covered lives in KY and OH. CGS has implemented this policy change after considering public comments made by Neuronetics, NeuroStar providers, and others.
NGS Medicare Administrative Contractor has published a proposed Local Coverage Decision (LCD) considering TMS coverage for obsessive-compulsive disorder (OCD) and is also considering an MDD policy criteria change that would reduce the number of prior medication failures for TMS eligibility from four down to two. Public comments are still being accepted through November 12, 2022 using this link: Proposed LCD – Transcranial Magnetic Stimulation (DL33398) (cms.gov). NGS is the Medicare Administrative Contractor for 6.3 million covered lives in IL, MN, CT, WI, NY, MN, MA, NH, RI, & VT.
“We are delighted to see payers adopting policies that reflect TMS as a standard of care for mental health,” said Keith J. Sullivan, President and CEO of Neuronetics. “The Neuronetics Health Policy & Reimbursement team has been instrumental in partnering with NeuroStar providers to address payer policy limitations. This is a key factor in driving favorable coverage decisions and expanding access for people who need a non-drug treatment option.”
Major depressive disorder (MDD) is a serious issue that affects 21 million adults in the United States, with 6.4 million people being underserved by antidepressant medication. NeuroStar TMS is a non-drug treatment that can help alleviate the burden of drug-resistant depression.
About Neuronetics
Neuronetics, Inc. believes that mental health is as important as physical health. As a global leader in neuroscience, Neuronetics is redefining patient and physician expectations with its NeuroStar Advanced Therapy for Mental Health. NeuroStar is a non-drug, noninvasive treatment that can improve the quality of life for people suffering from neurohealth conditions when traditional medication hasn’t helped. NeuroStar is FDA-cleared for adults with major depressive disorder (MDD), as an adjunct for adults with obsessive-compulsive disorder (OCD), and to decrease anxiety symptoms in adult patients with MDD that may exhibit comorbid anxiety symptoms (anxious depression). NeuroStar Advanced Therapy is the leading transcranial magnetic stimulation (TMS) treatment for MDD in adults with over 4.8 million treatments delivered. NeuroStar is backed by the largest clinical data set of any TMS system for depression, including the world’s largest depression Outcomes Registry. Neuronetics is committed to transforming lives by offering an exceptional treatment that produces extraordinary results. For safety and prescribing information, www.neurostar.com.
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