National Government Services issued a positive local coverage determination (LCD) for MIS SI joint fusion, effective 4/1/16. The LCD enables 9.5MM Medicare beneficiaries to access SI-BONE's iFuse procedure, if medically necessary, in 10 states.
NGS is the Medicare Administrative Contractor covering Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont and Wisconsin. This LCS brings the number of Medicare beneficiaries with access to iFuse to >45MM in 49 states and the District of Columbia. (First Coast Service Options of Florida the only MAC yet to provide coverage.)
SI-BONE's iFuse is the only MIS SI joint fusion system cleared by FDA with an indication citing clinical studies that demonstrate improved pain, function and quality of life out to 12 months post-implantation. iFuse is reported to be the only commercially available MIS SI joint fusion device in the U.S. with published clinical evidence demonstrating safety and effectiveness for SI joint fusion.
Source: SI-BONE, Inc.