Dignitana announces Medicare decision to reallocate payment for scalp cooling

STOCKHOLM, November 3, 2021 / PRNewswire / – Dignitana, Global Leader in Scalp Cooling Innovation Announces US Centers for Medicare & Medicaid Services (CMS) Reallocated Scalp Cooling Payment for Medicare Claims Filed Using Code CPT 0662T . This processing has been reallocated to the new APC 1520 technology with a national average payment of $ 1,850.50, effective January 1, 2022.

“This move ensures that thousands of cancer patients will now have access to life-changing scalp cooling treatment that was previously financially out of reach,” said Guillaume Cronin, CEO of Dignitana. “This is a milestone for Dignitana and for so many members of the cancer treatment community who have worked tirelessly to make scalp cooling the standard of care.”

“When the American Medical Association announced the CPT codes for scalp cooling last fall, we launched a plan to help the oncology community establish appropriate reimbursement. Medicare coverage is essential to our overall reimbursement efforts and will undoubtedly increase usage with existing customers and drive demand for DigniCap in new facilities, ”added Cronin.

CMS’s announcement comes after the agency previously released a National Coverage Determination (NCD) for scalp hypothermia during chemotherapy to prevent hair loss (scalp cooling) in June 2021 for APC 5732 (Minor Level 2 Procedures) with a proposed payment rate of $ 34.72. At that time, Dignitana filed an appeal with the agency and began conversations, working with Paxman Scalp Coolers, to determine an appropriate payment level for Medicare scalp cooling coverage.

An outpatient payment classification (APC) is the method used by the US government to pay facilities for outpatient services covered by Medicare. The new payment allocation allows for facility reimbursement under the Medicare Hospital Outpatient Prospective Payment System (OPPS).

According to CMS over 62 million people rely on Medicare for their health insurance coverage. A 2018 study found that 14.8 percent of all Medicare beneficiaries were diagnosed with cancer. In addition, in 2013, the American Cancer Society found that Medicare beneficiaries over the age of 65 account for 54 percent of all new cancer cases.

Approved by the FDA in 2015, the DigniCap Scalp Cooling System minimizes hair loss due to chemotherapy in patients with solid tumors. In the United States, the National Comprehensive Cancer Network® (NCCN) has added scalp cooling to its annual guidelines as a Class 2A recommendation for breast cancer patients in 2019 and breast cancer. ovary in 2020. These guidelines are widely recognized as the benchmark for cancer treatment coverage. and reimbursement by clinicians and payers. DigniCap is available in more than 250 sites in United States.

Resources:

1. CMS Final Decision November 2, 2022 – CMS-1753FC (page 232-233, scalp cooling)

2. CMS press release November 2, 2022 “CMS OPPS / ASC final rule increases price transparency, patient safety and access to quality care”

3. CMS Fact Sheet November 2, 2022 – Medicare CY 2022 Hospital Outpatient Prospective Payment System and Outpatient Surgery Center Payment System Final Rule (CMS-1753FC)

This disclosure contains information that Dignitana AB is obliged to make public in accordance with the EU Market Abuse Regulation (EU No 596/2014). The information has been submitted for publication, through the contact person, the 03-11-2021 07:55 GMT.

CONTACT:

For more information contact

Melissa Bourestom, Vice President of Corporate Communications, [email protected] +1 469-518-5031

This information was brought to you by Cision http://news.cision.com

https://news.cision.com/dignitana-ab/r/dignitana-announces-decision-by-medicare-to-reassign-payment-for-scalp-cooling,c3445904

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SOURCE Dignitana AB

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