Helius Medical announces preliminary CMS payment determination for PoNS

Helius Medical Technologies announced that the Centers for Medicare & Medicaid Services, CMS, posted proposed Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, DMEPOS, fee schedule payment rates for the PoNS Controller and Mouthpiece to be discussed at the bi-annual Healthcare Common Procedure Coding System Public Meeting, scheduled for May 29, 2024. For the PoNS Mouthpiece, CMS based pricing on the cash pay price of $4,500, resulting in a total capped payment of $3,075.53. For the PoNS Controller, CMS preliminarily set pricing by mapping reimbursement to existing code E0745, resulting in a total capped fee of $1,206.53. “CMS’s preliminary determination of reimbursement for both the PoNS Controller and Mouthpiece is a significant win for Helius,” stated Helius’ President and Chief Executive Officer, Dane Andreeff. “We intend to present at the HCPCS Public Meeting on May 29, 2024 and expand on how PoNS differs, mechanistically and therapeutically, from any neuromuscular peripheral stimulation therapy. We will present arguments to support a higher reimbursement rate for the PoNS Controller using the gap filling methodology, along with advocating for reimbursing the PoNS Mouthpiece through the lump sum payment structure at a higher rate than the one established in the preliminary determination.”