Myomo says CMS classifies MyoPro Orthosis under brace benefit category

Myomo announced that the Centers for Medicare & Medicaid Services published a final rule classifying the MyoPro under the brace benefit category. Braces are paid on a lump sum basis under the Social Security Act. The finalization of MyoPro’s classification as a brace paid on a lump sum basis, rather than on a capped rental basis, brings Medicare payment methodology in line with how all other insurance plans currently pay for the MyoPro. This rule is expected to be published in the Federal Register on November 13, 2023 and is effective on January 1, 2024. The MyoPro has already been covered and paid on a rental basis for five Medicare beneficiaries covering all of Medicare’s billing regions after review of their medical documentation. Future claims for devices delivered to patients are expected to continue to be reviewed on a claim-by-claim basis. Paul R. Gudonis, Myomo’s chairman and CEO, stated, “On behalf of the many stroke survivors and others with long term muscular weakness or partial paralysis with Medicare Part B insurance, we are pleased that CMS has moved forward to facilitate access to the MyoPro brace. The MyoPro has been shown to be effective for Medicare beneficiaries with the requisite medical necessity, and this reclassification is very supportive of CMS’ goal of health equity for this population.”