CMS proposes new reimbursement for Exparel in outpatient surgical enviroments

Pacira BioSciences announced that the Centers for Medicare and Medicaid Services CMS has issued its proposed Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2025. In the proposed rule, EXPAREL or bupivacaine liposome injectable suspension, is one of six covered non-opioids-two of which are specific to ophthalmology- qualifying for separate Medicare reimbursement in both the ambulatory surgical center, ASC, and hospital outpatient HOPD settings. Pending finalization, this policy would go into effect beginning January 1, 2025…”Following several years of advocacy for reimbursement policy reform to allow increased patient and provider access to non-opioids, we are pleased to see EXPAREL included as one of only six qualifying non-opioid drugs to treat postsurgical pain in the proposed rule,” said Frank D. Lee, Chief Executive Officer of Pacira. “As the only covered single-dose product approved for both local and regional analgesia across surgical procedures, we believe this new reimbursement-pending finalization-will offer clinicians increased ability to utilize a best-in-class option for achieving long-lasting non-opioid pain control with an increased ability to transition to the outpatient environment.”