Surgical Robotics company, PROCEPT® BioRobotics, has today announced that Aquablation therapy, delivered by the AquaBeam® Robotic System for the treatment of benign prostatic hyperplasia (BPH), will be fully covered for all Medicare patients in the United States effective December 27, 2020.
Medicare Administrative Contractors (“MACs”) First Coast Service Options, Inc (First Coast), Noridian Healthcare Solutions, LLC (Noridian), Novitas Solutions, Inc. (Novitas), GBA, LLC (Palmetto), and Wisconsin Physician Services (WPS) issued positive Local Coverage Determination policies for Aquablation therapy effective December 27, 2020. These five MACs join National Government Services (NGS) and CGS Administrators, LLC (CGS) who issued positive coverage policies for Aquablation therapy effective November 2020.
“In the United States, approximately 40 million men have BPH, a condition that significantly impacts quality of life,” said Reza Zadno, president and chief executive officer of PROCEPT BioRobotics. “We are grateful to all seven of the Medicare Administrative Contractors for working collaboratively to expand coverage for Aquablation therapy. The continued expansion of reimbursement coverage for Aquablation therapy ensures patients have access to an important treatment option that combines both the symptom relief generally associated with resective BPH treatments, and the reduced side effects generally associated with non-resective treatments.”
This recent Medicare announcement compliments positive coverage positions issued earlier in 2020 from Anthem and Humana, two of the nation’s leading health insurance providers. Anthem and Humana insure more than 42 million and 7 million lives nationwide, respectively, through their commercial and Medicare Advantage products.
“The decision to finalize these coverage policies was influenced by a significant amount of published data indicating Aquablation therapy is a safe and effective treatment that does not have the prostate size and shape limitations of many other BPH technologies,” said Dr. Claus Roehrborn, Professor and Chair of the Department of Urology, UT Southwestern Medical Center in Dallas, Texas. “Aquablation therapy is uniquely positioned to provide both long-lasting symptom relief and low rates of irreversible sexual dysfunction.