Inspire Medical Systems Sees Revenue Growth Amidst Coding and Reimbursement Uncertainty
Inspire Medical Systems has reported revenue growth in its first quarter 2026 financial results, despite challenges related to coding and reimbursement uncertainty.
According to Tim Herbert, Chairman and Chief Executive Officer of Inspire Medical Systems, the company's team executed well in the first quarter, delivering revenue growth and improved adjusted operating income and operating cash flow compared to the prior year period. This demonstrates the company's focus on prioritizing revenue-generating activities and maintaining disciplined cost management while continuing to make targeted investments to support long-term growth.
However, Herbert also highlighted the challenges faced by the company in terms of coding and reimbursement, including uncertainty surrounding the WISeR program. Despite these challenges, Inspire Medical Systems is diligently working to establish a consistent methodology for coding of its Inspire V procedure, with the goal of establishing a new CPT code for a single-lead Inspire system effective on January 1, 2028.
As part of this effort, the company has established short-term remedies for various payers to bridge until the new CPT code is in place. For centers concerned with the Inspire V reimbursement, Inspire Medical Systems has inventory of Inspire IV systems, which have proven themselves to be an extremely effective therapy with clear coding and reimbursement.
Additionally, there was progress made in the first quarter regarding coding for Inspire V systems, with physicians, centers, and payers working together to establish clear and consistent coding and reimbursement guidelines. For Medicare patients, the Centers for Medicare & Medicaid Services (CMS) announced the creation of a C-code to be used with Inspire V procedures, providing a reliable solution for hospitals and ambulatory surgical centers.
Importantly, this new C-code is equal to the Inspire IV CPT code 64582, and most Medicare cases billed without using a modifier. Inspire Medical Systems will continue to monitor this throughout the year.
