iRhythm: Novitas Revises Fee Schedule, ECG Monitoring and Analysis Payment Increases by Roughly 250% but Remains Significantly Lower than Previous Rates

Published on Apr 10, 2021

Earlier this morning, Medicare Administrative Contractor Novitas released an update to its 2021 fee schedule, increasing the rate for electrocardiographic monitoring (ECG) and analysis by roughly 250% and making the new prices retroactive to January 1.

The new rate, however, is still significantly lower than what iRhythm (IRTC) had been hoping for in 2021 and what the company had previously received for the service. Last year, iRhythm lobbied the Centers for Medicare and Medicaid Services to adopt a national rate of almost $400 in 2021, a rate which CMS declined to adopt, instead leaving the decision to Medicare Administrative Contractors like Novitas.

After CMS’ decision, Novitas initially reduced the 2020 rate from $311 to $42 for 2021, dealing a major blow to iRhythm, which dominates the ECG industry.

iRhythm, in conjunction with other ECG companies, has been lobbying Novitas to increase its reimbursement rate since January. That campaign appears to have been somewhat successful, given that those companies will now get roughly $103 and $114 for seven days and 14 days of ECG monitoring and analysis, respectively, when they bill in Novitas’ jurisdiction.

iRhythm did not immediately respond to a request for comment.