The following are examples of some of the successes that we have had on behalf of our clients across a wide variety of products and procedures:
Successfully lobbied CMS to move a device-related procedure from ASC Group 4 to Group 9.
Increased the practice expense component of a CPT code relative value unit to include a $250 cost increase for a device.
Established coverage for an office-based procedure in 43 of 50 state Medicaid programs.
Successfully positioned a number of drugs on Medicaid’s Preferred Drug Lists.
Effectively lobbied to edit a coding description for a drug.
Obtained coverage and reimbursement during the pivotal clinical trials for a number of Category B IDE technologies.
Established coverage and appropriate payment for a Category III CPT code with multiple state Medicare carriers and private insurance companies.
Achieved approximately 60 percent pull-through on a Medicare fee schedule increase that private insurance carriers were reluctant to update for an in-office procedure.
Received numerous CPT codes, ICD-9 procedure codes (with appropriate DRG assignments), new technology add-on payments, transitional pass-through codes, and HCPCS codes.
Lobbied the Federal Employees Health Program (FEHP) to cover a device/procedure that they historically would not consider.
