Caption Health has announced that the Centers for Medicare and Medicaid Services (CMS) have approved new technology add-on payments (NTAP) for the Caption Guidance AI-based software platform for Medicare patients receiving in-patient care.
Cases eligible for NTAP will have a newly created ICD-10 procedure code corresponding to Caption Guidance. The NTAP designation is awarded to new medical technologies and services which are expected to substantially improve the diagnosis or treatment of Medicare beneficiaries, and will go into effect October 1, 2021. Caption Guidance’s Breakthrough Designation from the US Food and Drug Administration (FDA) addresses the NTAP innovation and clinical efficacy requirements, and a subsequent application met the cost criterion to receive the NTAP designation.
The additional reimbursement covers Caption Guidance ultrasound acquisitions for 461 separate diagnostic resource groups (DRGs), including heart failure, stroke, and other common cardiac issues for inpatient care. With NTAP, hospitals would be eligible for an additional payment—up to a maximum amount—in cases where the costs of using this innovative technology exceed the payment under the corresponding DRG. Depending on the DRG and the hospital’s costs, the additional payment could be significant for the hospital.
“With the NTAP approval, America’s vulnerable senior population will have greater access to innovative AI-based guidance and interpretation technologies from Caption, which means ultrasound testing can be utilised as needed, offering the potential to positively impact treatment and outcomes,” said Steve Cashman, CEO of Caption Health. “We are on a mission to expand access to ultrasound diagnosis, and have already made strides through enabling a broader set of care team members to acquire diagnostic quality ultrasound studies. This NTAP designation helps to build upon that.”