The Medical Imaging & Technology Alliance (MITA) – the leading trade association representing manufacturers of medical imaging equipment, radiopharmaceuticals, contrast media, and focused ultrasound therapeutic devices – joined with the Focused Ultrasound Foundation to applaud the Centers for Medicare and Medicaid Services (CMS) final Calendar Year 2023 Outpatient Prospective Payment System (OPPS) reimbursement rule for including an increase in Medicare payment rates for ultrasound-guided high-intensity focused ultrasound (HIFU) prostate tissue ablation.
HIFU prostate tissue ablation treatment works by targeting ultrasound waves to destroy the diseased area of prostate tissue, leading to shorter recovery time and lower risk for life-altering side effects compared to other prostate cancer treatments. The current national reimbursement average for the HIFU procedure is $4,506, but the new OPPS rule will increase Medicare reimbursement to $8,558 per procedure.
“This ruling is especially exciting because it is something we have been advocating for with patients, doctors, manufacturers and MITA for some time,” said Jessica Foley, PhD, the Foundation’s chief scientific officer and managing director, government affairs. “We know that focused ultrasound offers many benefits for patients, but we are also aware that in order for the treatment to become widely available, it needs to be profitable for hospitals. This ruling will ensure that this treatment option is a worthwhile investment for providers.”
“Patients will now see greater access and availability for HIFU prostate cancer treatment thanks to this new policy,” said Patrick Hope, executive director of MITA. “CMS was right to support this minimally invasive treatment option that can effectively combat prostate cancer, reduce debilitating side effects, and lower downstream medical costs for patients.”