REIMBURSEMENT SUPPORT
At Insightec, we are committed to helping providers and patients navigate the reimbursement process for MR-guided Focused Ultrasound (MRgFUS) therapy. Our goal is to ensure access to treatment by providing the tools, resources, and support needed to secure coverage.
Support for Providers
Our dedicated reimbursement team is available to assist healthcare professionals with:
- CPT and ICD-10 coding guidance
- Benefits verification
- Prior authorization and predetermination support
- Appeals for denied claims
- Documentation best practices to support medical necessity
Reimbursement Resources
We offer a comprehensive MR-Guided Focused Ultrasound Reimbursement Guide that includes:
- Covered indications and diagnosis codes
- Medicare and commercial payor coverage landscape
- CPT coding and payment information
- Documentation tips for medical necessity
- State-by-state coverage insights
Download the MRgFUS Reimbursement Guide
Established Reimbursement
Focused ultrasound for essential tremor has established reimbursement nationwide, making access more seamless for patients and providers.
- Medicare coverage available in all 50 states
- Favorable coverage from the majority of national private payers (Aetna, Anthem, Cigna, Humana, BlueCross BlueShield, Tricare, and others)
- Nationwide reach with treatment centers across the country
- CPT Category I code effective January 1, 2025 for routine physician payment
- 235M+ lives covered across the U.S.
Patient Advocacy Program
If your patient’s insurance does not currently cover Insightec’s MR-guided focused ultrasound therapy, our Patient Advocacy Program may be able to help. This program is designed to:
Educate
Provide insurance providers with information on the clinical and economic value of MR-guided focused ultrasound
Support
Support patients and providers through the prior authorization or appeals process
Assist
Offer personalized assistance from our reimbursement support team
Patient Requirements:
- Patients must agree to participate by completing an authorization form provided by the program coordinator.
- Patients must work with their provider(s) and the support representative to provide the documentation needed to initiate authorization, predetermination, or appeal with their insurance company.
Expected Outcome:
The program’s purpose is to educate insurance providers on focused ultrasound so appropriate patients can gain access to this treatment.
Contact:
To learn more or to participate, contact our Patient Advocacy team:
📞 1‑866‑EXABLATE (1‑866‑392‑2528)
✉️ kimberlym@insightec.com
Disclaimer
The information provided is for educational purposes only and should not be considered as authoritative. Coverage and reimbursement are affected by numerous factors and may vary across payors and geographies. Codes, values, and policies are subject to change without notice.
Insightec does not guarantee success in obtaining third‑party insurance approvals or reimbursement. Providers are responsible for using the appropriate codes, modifiers, and charges for services rendered. Please consult payors, Medicare Administrative Contractors, or institutional compliance departments for specific requirements.