Helius Medical Technologies, Inc. Announces Preliminary CMS Payment Determination of Reimbursement for Portable Neuromodulation Stimulator (PoNS®)
06 Mai 2024 - 3:00PM
Helius Medical Technologies, Inc. (Nasdaq:HSDT) (“Helius” or
the “Company”), a neurotech company focused on delivering a novel
therapeutic neuromodulation approach for balance and gait deficits,
today 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 (HCPCS) Public
Meeting, scheduled for May 29, 2024.
For the PoNS Mouthpiece (HCPCS code A4594), 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 (HCPCS Code A4593), CMS
preliminarily set pricing by mapping reimbursement to existing code
E0745, (Neuromuscular stimulator, electronic shock unit), 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.”
“Once the decision is finalized, the payment rates will be
effective October 1, 2024. We believe Medicare price determination
will allow us to expand reimbursement across third-party payers and
give us a pathway to positive cash flow as we continue pursuing
authorization for stroke in the U.S.”
The preliminary payment determinations published by CMS for
discussion at the Public Meeting are only proposed fee schedule
rates. The Company cannot provide any assurance that these rates
will be finalized and adopted in their current amounts, or at
all.
About Helius Medical Technologies,
Inc.
Helius Medical Technologies is a leading neurotech company in
the medical device field focused on neurologic deficits using
orally applied technology platform that amplifies the brain’s
ability to engage physiologic compensatory mechanisms and promote
neuroplasticity, improving the lives of people dealing with
neurologic diseases. The Company’s first commercial product is the
Portable Neuromodulation Stimulator. For more information about the
PoNS® or Helius Medical Technologies, visit
www.heliusmedical.com.
About the PoNS Device and PoNS Therapy
The Portable Neuromodulation Stimulator (“PoNS”) is an
innovative, non-implantable, orally applied therapy that delivers
neurostimulation through a mouthpiece connected to a controller and
it’s used, primarily at home, with physical rehabilitation
exercise, to improve balance and gait. The PoNS device, which
delivers mild electrical impulses to the tongue, is indicated for
use in the United States as a short-term treatment of gait deficit
due to mild-to-moderate symptoms from multiple sclerosis (“MS”) and
is to be used as an adjunct to a supervised therapeutic exercise
program in patients 22 years of age and over by prescription
only.
PoNS has shown effectiveness in treating gait or balance and a
significant reduction in the risk of falling in stroke patients in
Canada, where it received authorization for sale in three
indications: (i) for use as a short-term treatment (14 weeks) of
gait deficit due to mild and moderate symptoms from stroke and is
to be used in conjunction with physical therapy; (ii) for use as a
short-term treatment (14 weeks) of chronic balance deficit due to
mild-to-moderate traumatic brain injury (“mmTBI”) and is to be used
in conjunction with physical therapy; and (iii) for use as a
short-term treatment (14 weeks) of gait deficit due to mild and
moderate symptoms from MS and is to be used in conjunction with
physical therapy. PoNS is also authorized for sale in Australia for
short term use by healthcare professionals as an adjunct to a
therapeutic exercise program to improve balance and gait. For more
information visit www.ponstherapy.com.
Cautionary Disclaimer Statement
Certain statements in this news release are not based on
historical facts and constitute forward-looking statements or
forward-looking information within the meaning of the U.S. Private
Securities Litigation Reform Act of 1995 and Canadian securities
laws. All statements other than statements of historical fact
included in this news release are forward-looking statements that
involve risks and uncertainties. Forward-looking statements are
often identified by terms such as “believe,” “expect,” “continue,”
“will,” “goal,” “aim” and similar expressions. Such forward-looking
statements include, among others, statements regarding the fees
published by CMS for PoNS and the potential for reimbursement in
October 2024.
There can be no assurance that such statements will prove to be
accurate and actual results and future events could differ
materially from those expressed or implied by such statements.
Important factors that could cause actual results to differ
materially from the Company’s expectations include uncertainties
associated with the Company’s capital requirements to achieve its
business objectives, availability of funds, the Company’s ability
to find additional sources of funding, manufacturing, labor
shortage and supply chain risks, including risks related to
manufacturing delays, the Company’s ability to obtain national
Medicare insurance coverage and to obtain a reimbursement code, the
Company’s ability to continue to build internal commercial
infrastructure, secure state distribution licenses, market
awareness of the PoNS device, future clinical trials and the
clinical development process, the product development process and
the FDA regulatory submission review and approval process, other
development activities, ongoing government regulation, and other
risks detailed from time to time in the “Risk Factors” section of
the Company’s Annual Report on Form 10-K for the year ended
December 31, 2023, and its other filings with the United States
Securities and Exchange Commission and the Canadian securities
regulators, which can be obtained from either at www.sec.gov or
www.sedar.com.
The reader is cautioned not to place undue reliance on any
forward-looking statement. The forward-looking statements contained
in this news release are made as of the date of this news release
and the Company assumes no obligation to update any forward-looking
statement or to update the reasons why actual results could differ
from such statements except to the extent required by law.
Investor Relations Contact Lisa M. Wilson,
In-Site Communications, Inc. T: 212-452-2793 E:
lwilson@insitecony.com
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