William Blair Downgrades Glaukos After Disappointing CMS Rate; Shares Drop

  • Centers for Medicare and Medicaid Services (CMS) issued its fiscal 2022 proposed physician fee schedule, which included two combined Category I cataract plus stent procedure codes.
  • The physicians will use the codes to seek reimbursement utilizing Glaukos Corporation's GKOS trabecular micro-bypass technologies (iStent, iStent inject, iStent inject W) when used as approved in combination with cataract surgery.
  • Glaukos estimates a proposed 2022 physician fee of approximately $565.23, representing incremental physician fee payment for the insertion of an aqueous draining device of roughly $34.25 versus the proposed 2022 physician fee of roughly $530.98 for non-complex cataract surgery alone.
  • William Blair downgraded Glaukos to Market Perform from Outperform, noting a "disappointing and surprising" preliminary physician reimbursement rate for a code that will combine cataract surgery and the iStent procedure into one code.
  • Analyst Brian Weinstein writes that the proposed rate calls for incremental reimbursement for the iStent procedure to be approximately $34, well below the analyst's expectation of somewhere just south of $300. 
  • The proposed rate represents an approximately 90% cut to the current rate at which most procedures are reimbursed under the Category III code, says Weinstein. He believes this will put an overhang on Glaukos shares.
  • Price Action: GKOS shares are down 18.5% at $59.95 during the premarket session on the last check Wednesday.
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