Second Sight Medical Products announced the Argus II Retinal Prosthesis System can now be covered by Medicare in seven of the 12 Medicare Administrative Contractor (MAC) jurisdictions nationwide, representing a total of 28 states, two territories, and the District of Columbia.
The MAC for jurisdictions JH and JL, Novitas Solutions, Inc., published a local coverage determination removing the Category III Current Procedural Terminology Code that describes the Argus II placement procedure (0100T) from the listing of codes that are considered not reasonable and necessary. This decision authorizes coverage of Argus II, when medically necessary, to Medicare beneficiaries in Arkansas, Colorado, Delaware, Louisiana, Maryland, Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania, Texas, and the District of Columbia.
By allowing Medicare coverage for Argus II, Novitas joins MACs CGS Administrators (jurisdiction J15), Palmetto GBA (jurisdiction JM), National Government Services (jurisdictions J6 and JK), and First Coast Service Options (jurisdiction JN).
“We are pleased that Novitas has made this important decision to facilitate coverage of the Argus II, which we believe will enable us to offer greater access to patients with Retinitis Pigmentosa and continue to fulfill our mission of providing useful vision to the blind," Will McGuire, President and CEO of Second Sight, said in a company news release.
Second Sight continues to work with other MACs and payers to secure affirmative coverage policies for the Argus II and to ensure that Medicare beneficiaries nationwide have access to this revolutionary technology.