NEWTOWN, PA — Helius Medical Technologies, Inc. (Nasdaq: HSDT) announced this week that it has secured its first third-party reimbursement from a major insurance carrier for its Portable Neuromodulation Stimulator (PoNS®) device. This marks a significant milestone for the company in making its innovative therapy more accessible to patients.
Dane Andreeff, President and CEO of Helius, expressed enthusiasm about the achievement. “Securing widespread reimbursement for PoNS remains a top priority for us, and we are thrilled to announce that we’ve received our first third-party reimbursement at the list price with a 7% rebate by a major insurance carrier,” said Andreeff.
The PoNS device, which aids in neurological rehabilitation, received unique Healthcare Common Procedure Coding System codes from the Centers for Medicare & Medicaid Services (CMS). This coding is crucial as it helps standardize billing and facilitates reimbursement negotiations with insurers. Helius has been actively pursuing these discussions and is also working with the Veterans Administration and the Department of Defense through a partnership with Lovell Government Services.
The accepted reimbursement rate, after a 7% rebate, prices the PoNS controller at $16,554 and the mouthpiece at $7,347. This pricing sets a precedent that could influence future negotiations with other insurance providers.
Helius Paving the Way for Neuromodulation Therapies
For Helius, this development is vital. Achieving third-party reimbursement bolsters the commercial viability of the PoNS device and validates its clinical utility. It also eases the financial burden on patients who might otherwise struggle to afford the therapy.
The broader implications for the healthcare market are noteworthy. As more insurers potentially follow suit, access to advanced neuromodulation therapies like PoNS could expand, offering new hope to patients with neurological conditions. This initial reimbursement may act as a catalyst, encouraging further adoption and integration of similar medical innovations into standard care practices.
Helius plans to continue its efforts to secure additional reimbursement agreements, which would further solidify the device’s market position. This strategy includes assisting multiple sclerosis (MS) patients in submitting claims to other insurers, aiming to establish consistent reimbursement rates across different carriers.
This move highlights the importance of strategic partnerships and regulatory approvals in the medical technology sector. By navigating these complexities, companies like Helius can bring transformative therapies to market, ultimately improving patient outcomes and driving progress in medical treatments.
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