Inspire Medical Systems: Temporary MAC-CMS Reimbursement Misalignment Creates Overdone Pullback, Supporting Continued Buy Rating

In a report released today, Richard Newitter from Truist Financial maintained a Buy rating on Inspire Medical Systems, with a price target of $165.00.

Richard Newitter has given his Buy rating due to a combination of factors tied to reimbursement dynamics and the underlying durability of Inspire Medical Systems’ growth story. He notes that while the recent Medicare Administrative Contractor (MAC) decisions to remove CPT 64568 have driven significant share volatility, these moves appear to conflict with formal CMS guidance that explicitly maps obstructive sleep apnea indications to this code and upgrades it to a higher-paying reimbursement category. In his view, CMS’ prior actions and “mandatory” transmittal language suggest that MACs will ultimately need to realign their policies with CMS, even if they initially create administrative friction and short‑term uncertainty. He also emphasizes that the coding change reflects a more appropriate matching of reimbursement to the actual work associated with Inspire’s latest-generation system, rather than a negative reassessment of the therapy’s clinical value.

At the same time, Newitter acknowledges that MAC-level resistance and policy reversals could slow adoption in 2026 by introducing extra appeal steps and administrative hurdles for providers. However, based on feedback from reimbursement specialists, he views these issues as process-oriented and likely temporary, not structural threats to long-term coverage. With shares down sharply on what he characterizes as a confusing and still-evolving reimbursement situation, he sees the pullback as overdone relative to the fundamental outlook and the expectation that CMS’ framework will ultimately prevail. This combination of regulatory misalignment that should normalize over time, continued institutional incentives to bill under the higher-paying code, and a strong underlying demand profile supports his decision to maintain a Buy rating on INSP.

In another report released today, Piper Sandler also maintained a Buy rating on the stock with a $165.00 price target.