The Official Newsletter ofCentinel Spine®

Top Commercial Payer in Tennessee Establishes prodisc® L Positive Coverage for 1 & 2 Levels

Steve Sanderson

This March 1, 2024 coverage adoption represents over 2.3 million covered lives.

Centinel Spine recently announced, via a press release, significant expansion of coverage for lumbar total disc replacement (TDR) procedures in the state of Tennessee.

The policy expansion announced by Tennessee’s largest commercial payer—effective March 1, 2024—represents over 2.3 million covered lives across the state and includes a positive coverage recommendation for both one- and two-level lumbar TDR. Because prodisc L is the only lumbar TDR device with FDA approval for two-level use, the two-level coverage recommendation only applies to the use of the prodisc L lumbar device.

This major positive coverage update continues the trend toward significant coverage for one- and two-level lumbar TDR, as the coverage expansion reported in 2023 totaled a combined 24.5 million covered lives across the states of Illinois, New Mexico, Oklahoma, Texas, Michigan, and North Carolina.

With this favorable coverage expansion in Tennessee, it is estimated that coverage for one-level lumbar TDR has grown from 50% of covered lives in 2017 to almost 95%* today—and that over 30% of commercially-covered lives in the U.S. now have access to two-level lumbar TDR, as well.

 

* Data on file, estimate based on combined positive and neutral policies.

 

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