Reimbursement Blog

kathryn-barry-at-desk-225x300Welcome to KBA’s Reimbursement Blog. Our purpose is to provide an educational forum for busy medical device professionals. On a daily basis, we monitor the Federal Register, CMS, AMA, professional society and leading payer websites for announcements about medical device codes, coverage and/or reimbursement changes. When we find something interesting, this forum provides us with an opportunity to share it with our colleagues. Through the years, we’ve learned that knowledge is power!

What differentiates KBA from other reimbursement consultants is our direct hands-on experience with medical device sales and marketing for more than 25 years. KBA was there for the beginning of laparoscopic surgery in the early 1990s, for the explosion of minimally invasive cardiac surgery in the mid-1990s, and percutaneous innovations in spine surgery in the early 2000s.  We know how to translate policy into practical business solutions. While we enjoy researching health policy, we are known for our ability to anticipate changes and incorporate them into our client’s strategic business plans. In the area of medical device coding, coverage and reimbursement, what you don’t know can definitely hurt your bottomline.  Through this blog, we want to share education and information about the complexities of U.S. healthcare financing and delivery. Consider this a quick “heads-up” on a new development that will soon impact medical device sales and marketing.

We hope you find a practical pearl of wisdom for your medical device. If you do, please let us know!


On July 31, 2015, the world stopped spinning for a split second and my life changed forever from a car crash that took the life of my wonderful husband, Jon. Work, family, faith and friends have helped push me forward.  Every day since that fateful night…

The purpose of this memo is to summarize key findings in Medicare’s CY16 PROPOSED Hospital Outpatient Prospective Payment System (HOPPS) rule, as posted on Medicare’s website on July 1, 2015. The anticipated date of publication in the Federal Register is 7/8/2015….

FYI: Please take a moment to skim the attached two headlines in today’s news and feel free to share them with your sales team:  Medical Center of Central Georgia, Macon, Georgia agrees to pay $20-million (Modern Healthcare (4-28-15) for improperly billing short-term…

4/20/2015 – The purpose of this memo is to summarize key points raised in Medicare’s FY16 Inpatient Prospective Payment System (IPPS) proposed rule, as released on 4/17/15 @ www.cms.gov. Please consider this a preliminary assessment pending additional review of the…

Key decisions from Medicare’s FY2015 Hospital Outpatient Prospective Payment System (HOPPS)-Final rule published on www.cms.gov on November 1, 2014 and in the Federal Register on November 10, 2014.  These changes become effective January 1, 2015. General impact: For CY 2015,…

On 10/31/14, Medicare released the CY2015 Physician Fee Schedule (PFS) final rule on its website (www.cms.gov).  This final rule has not yet been published in the Federal Register.  Key decisions include: 2015 Conversion Factor (CF) (page 534): Physician Fee Schedule …

Thousands of pages have been released by Medicare over the past three months regarding proposed and final 2015 payments to physicians, hospitals and free-standing Ambulatory Surgery Centers (ASCs).  For the busy medical device executive, I encourage you to skim this…

The new joint venture recently announced by Anthem and seven prominent Southern California healthcare systems, Vivity, is not good news for medical device companies selling premium priced innovation and/or expensive “commodity” products.  Consider this another shot across the bow, along…

The purpose of this document is to provide a summary of Medicare’s CY2014 Physician Fee Schedule (PFS) Proposed Rule. It was placed on display @ www.cms.gov on July 08, 2013 and will be published in the Federal Register on July…