CMS Finalizes New Billing Code for Posterior SI Joint Fusion to Be In-office Procedure

TAMPA, FL – November 3, 2023 – The Centers for Medicare & Medicaid Services (CMS) has finalized its decision to establish payment rates for PainTEQ’s new Current Procedural Terminology (CPT^®) code for posterior SI joint fusion in the office setting in addition to hospital outpatient departments (HOPDs) and Ambulatory Surgery Centers (ASCs). This change for PainTEQ‘s LinQ SI Joint Stabilization procedure redefines the landscape of SI joint pain management for Medicare patients.

The final 2024 Medicare national average physician professional fee is $11,934 for office-based procedures and $459 when the physician performs the service in a facility setting such as an ASC or HOPD.  This decision to expand the place of service is expected to streamline the procedure’s accessibility and affordability.

“The ability to offer posterior SIJ fusion for Medicare beneficiaries as an office procedure is not just a procedural update; it is a paradigm shift in how we approach patient care. This change allows us to bring advanced, minimally invasive treatments like the LinQ procedure directly to our physician’s patients in a more comfortable and familiar setting, significantly enhancing their overall treatment experience,” stated Sean LaNeve, CEO of PainTEQ.

“The integration of an in-office billing code for posterior SI joint fusion into Medicare’s framework is a testament to the evolving nature of medical technology and patient care. Procedures like PainTEQ’s LinQ, which can now be performed in an office setting, reflect our commitment to adopting innovative techniques that prioritize patient safety, comfort, and outcomes. This approval is a significant advancement in our ability to treat SI Joint pain more efficiently and effectively,” said Nomen Azeem, MD.

PainTEQ’s dedication to clinical excellence is evident through its robust clinical studies, which emphasize the safety and efficacy of the LinQ procedure. The company’s proactive collaborations with professional societies, CMS, and patient advocacy groups have been instrumental in championing the cause. Notably, PainTEQ stands out with its unique in-office surgery-ready instruments specifically tailored to treat SIJ disease.

“The ability to offer in-office treatment for posterior SIJ fusion represents a crucial step in making comprehensive pain management more accessible. It enables us to offer cutting-edge treatments like PainTEQ’s LinQ procedure in a way that is not only clinically effective but also cost-effective for our patients. This is especially vital for our Medicare population, who often face challenges in accessing advanced medical care,” according to Jeff Henn, MD.

PainTEQ continues its trajectory as a leader in SI Joint pain solutions, with CMS’s final decision further solidifying its position in the medical community.

About PainTEQ:  PainTEQ was built to bring interventional procedures to the market.  Working with pain management specialists to help reduce and eliminate SI joint dysfunction, PainTEQ’s LinQ implant aims to immediately provide clinical benefits to individuals living with incapacitating lower back pain through a minimally invasive outpatient procedure.  Learn more at www.painteq.com.

About LinQ: The LinQ SI Joint Stabilization System provides patients with a minimally invasive option to combat pain due to sacroiliac disease. After a thorough diagnostic process, physicians may help alleviate, and in many cases eliminate, chronic pain by placing a single LinQ allograft into the SI joint.