Profound Medical Corp. (NASDAQ:PROF; TSX:PRN) (“Profound” or the
“Company”), a commercial-stage medical device company that develops
and markets customizable, incision-free therapies for the ablation
of diseased tissue, today announced that U.S. Centers for Medicare
and Medicaid Services (CMS) has issued its proposed rules
establishing, for the first time, a Category 1 CPT code for the
Transurethral Ultrasound Ablation (“TULSA”) procedure, effective
January 1, 2025.
According to the proposed rule, TULSA will have
3 physician codes to cover how therapy is delivered depending on if
there are one or two physicians involved in the procedure: 5x006
TULSA Device Management and 5x007 TULSA Treatment, when two
physicians are involved in the procedure, and 5x008 TULSA Complete
Procedure, when performed by a single physician. TULSA will have a
0-day global period, indicating that the payment associated with
the codes will only cover the work performed on the day TULSA is
performed. Physicians will thereby bill for any pre or post patient
visit separately using existing codes. This will provide physicians
with the most flexibility to assess the appropriate number of
visits needed by each patient and enable their safe and fast
recovery. TULSA codes have also been assigned to all three sites of
service: Hospital Outpatient (“HOPD”), Ambulatory Surgical Center
(“ASC”), and Private Office/Non-Facility (“OBL”). The spectrum of
the location of service will ensure patients can be treated in
whatever setting they and their physician believe appropriate and
convenient for each patient.
For Hospital Payment, the proposed rule has
established TULSA as a Level 6 Urology Ambulatory Payment
Classification (“APC”) for 2025 for 5x008 of $9,208.50 (National
Average). For ASCs, the facility payment for 5x008 will be
$7,195.00 (National Average).
The Proposed Rule for the Physician Fee Schedule
has set the total Facility (HOPD or ASC) Relative Value Units
(“RVU”) at 6.53 for TULSA Device Management 5x006 and 14.68 RVU for
the TULSA Treatment Physician 5x007 when 2 physicians are involved
in the TULSA procedure. If one physician performs the complete
TULSA procedure, the RVU is 18.01 for 5x008.
The Proposed Rule for Physician fee schedule for
Non-Facility (OBL or Private Office) has set RVU at 16.50 for TULSA
Device Management 5x006 and 267.47 RVU for the TULSA Treatment
Physician 5x007 when 2 physicians are involved in the TULSA
procedure. If one physician performs the complete TULSA procedure,
the RVU is 276.65 for 5x008.
As noted above, the TULSA procedure will have a
0-day Global Period, which does not include payment for
post-operative visits, while all other comparable prostate
treatment procedures include payments for post-operative visits
performed in the first 90 days. The typical range of post-operative
office visits would be approximately 9-11 total RVUs in the first
90-days.
The below tables summarize the proposed rule
Codes, RVUs and Facility Dollar Amounts.
Facility Fee Schedule:
CPT Code |
Description |
APC: HOPD |
APC: ASC |
5x008 |
TULSA Complete Procedure |
$9,208.50 |
$7,195.00 |
Physician Fee Schedule:
CPT Code |
Description |
Physician Total RVU |
Typical 90-Day Follow-up |
Physician Total RVU with typical 90-day
Follow-Up |
Facility (HOPD, ASC) |
Non-Facility (OBL) |
Facility |
Non-Facility (OBL) |
(HOPD, ASC) |
5x006 |
TULSA Device Management |
6.53 |
16.50 |
9.39-11.67 |
15.92-18.20 |
25.89 - 28.17 |
5x007 |
TULSA Treatment |
14.68 |
267.47 |
n/a |
14.68 |
267.47 |
5x006 & 5x007 Total |
Procedure Total |
21.21 |
283.97 |
9.39-11.67 |
30.60-32.88 |
293.36 - 295.64 |
(Two Physician) |
|
5x008 |
TULSA Complete Procedure (One Physician) |
18.01 |
276.65 |
9.39-11.67 |
27.40-29.68 |
286.04 - 288.32 |
About Profound Medical Corp.
Profound is a commercial-stage medical device
company that develops and markets customizable, incision-free
therapies for the ablation of diseased tissue.
Profound is commercializing TULSA-PRO®, a
technology that combines real-time MRI, robotically-driven
transurethral ultrasound and closed-loop temperature feedback
control. TULSA-PRO® is designed to provide customizable and
predictable radiation-free ablation of a surgeon-defined prostate
volume while actively protecting the urethra and rectum to help
preserve the patient’s natural functional abilities. TULSA-PRO® has
the potential to be a flexible technology in customizable prostate
ablation, including intermediate stage cancer, localized
radio-recurrent cancer, retention and hematuria palliation in
locally advanced prostate cancer, and the transition zone in large
volume benign prostatic hyperplasia (“BPH”). TULSA-PRO® is CE
marked, Health Canada approved, and 510(k) cleared by the U.S. Food
and Drug Administration (“FDA”).
Profound is also commercializing Sonalleve®, an
innovative therapeutic platform that is CE marked for the treatment
of uterine fibroids and palliative pain treatment of bone
metastases. Sonalleve® has also been approved by the China National
Medical Products Administration for the non-invasive treatment of
uterine fibroids and has FDA approval under a Humanitarian Device
Exemption for the treatment of osteoid osteoma. The Company is in
the early stages of exploring additional potential treatment
markets for Sonalleve® where the technology has been shown to have
clinical application, such as non-invasive ablation of abdominal
cancers and hyperthermia for cancer therapy.
Forward-Looking Statements
This release includes forward-looking statements
regarding Profound and its business which may include, but is not
limited to, the expectations regarding the efficacy of Profound’s
technology in the treatment of prostate cancer, BPH, uterine
fibroids, palliative pain treatment and osteoid osteoma; CMS’ final
CY2025 Rule for TULSA, which is currently anticipated to be
published in November 2024; and the success of Profound’s U.S.
commercialization strategy and activities for TULSA-PRO®. Often,
but not always, forward-looking statements can be identified by the
use of words such as "plans", "is expected", "expects",
"scheduled", "intends", "contemplates", "anticipates", "believes",
"proposes" or variations (including negative variations) of such
words and phrases, or state that certain actions, events or results
"may", "could", "would", "might" or "will" be taken, occur or be
achieved. Such statements are based on the current expectations of
the management of Profound. The forward-looking events and
circumstances discussed in this release, may not occur by certain
specified dates or at all and could differ materially as a result
of known and unknown risk factors and uncertainties affecting the
Company, including risks regarding the medical device industry,
regulatory approvals, reimbursement, economic factors, the equity
markets generally and risks associated with growth and competition.
Although Profound has attempted to identify important factors that
could cause actual actions, events or results to differ materially
from those described in forward-looking statements, there may be
other factors that cause actions, events or results to differ from
those anticipated, estimated or intended. No forward-looking
statement can be guaranteed. In addition, there is uncertainty
about the spread of the COVID-19 virus and the impact it will have
on Profound’s operations, the demand for its products, global
supply chains and economic activity in general. Except as required
by applicable securities laws, forward-looking statements speak
only as of the date on which they are made and Profound undertakes
no obligation to publicly update or revise any forward-looking
statement, whether as a result of new information, future events,
or otherwise, other than as required by law.
For further information, please contact:
Stephen KilmerInvestor Relationsskilmer@profoundmedical.comT:
647.872.4849
Susan ThomasPublic Relationssthomas@profoundmedical.comT:
619.540.9195
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