Inspire reimbursement unchanged as CMS confirms APC 5465 mapping, says Stifel

CMS confirmed that the new HGNS C-codes will be assigned to APC 5465, the same APC as CPT 64582, keeping the hospital facility fee at approximately $31,500 and leaving Inspire Medical’s (INSP) overall reimbursement essentially unchanged, Stifel tells investors in a research note. While this removes downside risk, including the possibility of reverting to Inspire IV, uncertainty remains around the physician fee and the impact of the -52 modifier pending further MAC guidance, the firm says. Stifel has a Buy rating on Inspire Medical shares.