Boston, MA – FIGUR8 recently announced that the American Medical Association (AMA) has issued a new technology-specific Category III Current Procedural Terminology (CPT®) code for FIGUR8’s musculoskeletal technology. The AMA CPT Editorial Panel accepted FIGUR8’s request to add a Category III code for use of FIGUR8’s sensor fusion system combining inertial measurement system (IMU) and Surface Mechanomyography (sMMG), a proprietary technology developed by FIGUR8 to accurately assess muscle function and health.
“FIGUR8’s sensor fusion system provides the best-in-class biomarkers for musculoskeletal health and we are delighted that the American Medical Association has approved FIGUR8’s application for adding a new Category III CPT Code — the AMA’s first-ever billing code issued for such a procedure,” said Nan-Wei Gong, CEO and founder of FIGUR8. “The AMA issuance provides new pathways to enable wide adoption and dramatically expand the access of FIGUR8’s technology platform among clinicians and providers. As the first time the AMA has recognized digital physical examinations as a procedure, the new CPT code is particularly a game changer in providing new reimbursement channels for physical therapy providers.”
The specific code was granted after review and validation of FIGUR8’s technology by the AMA CPT Editorial Panel. The CPT codes created and maintained by the AMA CPT Editorial Panel are the most widely accepted medical language by government payers, including Medicare and Medicaid, and commercial health plans to describe healthcare services and procedures for reimbursement. The approved Category III CPT code will be in effect for at least five years, at which time the AMA may award a Category I code. Category III CPT codes serve as an important milestone for FDA approval and payment negotiations. While the code has been already posted to the AMA website, the new CPT code goes into effect in the CPT codebook on January 1, 2023.
“This milestone further advances FIGUR8’s efforts in equipping orthopedic providers with the most accurate precision analytics for measuring musculoskeletal function and with better tools for clinical efficacy,” said Dr. Michael Oberlander, Chief Medical Officer of FIGUR8. “AMA’s new code is the first major step towards obtaining a CAT I permanent code attached to RVUs for insurance billing, and establishes the foundation for reimbursement of FIGUR8’s solution for digital clinical exams.”
FIGUR8’s advanced musculoskeletal assessment solution — developed over years of R&D by MIT engineers in collaboration with Mass General Brigham clinicians — enables a full musculoskeletal and orthopedic assessment to be conducted in minutes. In less than 15 minutes, the FIGUR8 solution can deliver data on key musculoskeletal biomarkers — including dynamic range of motion, movement quality, strength and functional mobility — in order to create an individualized and precise plan of care.
“FIGUR8 is spearheading the digital transformation of physical exams. As lead scientist for the initial development research of the surface mechanomyography (sMMG) sensor, I am extremely proud of the company’s recent accomplishment,” said Dr. Donna Moxley Scarborough, PT, MS, PhD, Senior Sports Medicine Research Scientist in the Department of Orthopaedic Surgery at Massachusetts General Hospital. “This milestone for FIGUR8 exemplifies the power of collaborative efforts across clinicians, researchers, biomechanists, engineers and data scientists culminating to provide the healthcare community with an impactful new assessment tool for musculoskeletal health that has not been possible before. The AMA’s issuance of a new CPT code for FIGUR8’s sMMG sensor for use in the clinical setting is a crucial step for applying this technology to help clinicians better monitor muscle integrity for both musculoskeletal injury recovery and prevention.”
The clinical benefits of FIGUR8’s musculoskeletal assessment system are backed by numerous published clinical studies from Mass General Brigham and Harvard University and an ongoing clinical study with Stanford Medical School.
“As an academic orthopaedic spine surgeon, I was delighted to hear about FIGUR8 obtaining approval for a novel AMA CPT CAT III code for their musculoskeletal measurement technology. They have additionally notified us of their recent HITRUST certification,” said Todd Alamin, MD, Professor of Orthopaedic Surgery, Division Orthopaedic Spine, Stanford University School of Medicine. “This commitment to the security of PHI is extremely important for us when engaging with industry partners. As someone who is currently implementing their technology to evaluate my patients in a RCT on Spinal Stenosis treatment, these recent milestone accomplishments by FIGUR8 provide further affirmation of their commitment to the quality, value and security of the data being produced.”
FIGUR8’s technology is in deployments with major health systems, insurance carriers, and government organizations. FIGUR8’s technology drives significant improvements in patient outcomes and lowers re-injury rates while generating significant cost savings for employers, healthcare systems and both commercial health and casualty insurance carriers. More than 1.7 billion people suffer from musculoskeletal conditions, according to the World Health Organization. Musculoskeletal disorders account for one of the largest categories of workplace injuries, accounting for over 50 percent of workers’ compensation costs according to the Bureau of Labor Statistics.