The Official Newsletter ofCentinel Spine®

Coverage Expansion Continues for One- and Two-level Lumbar Total Disc Replacement as Top Commercial Payers in Mid-Atlantic Region Extend Positive Coverage for Centinel Spine’s prodisc® L

Steve Sanderson

These recent coverage adoptions represent nearly 3 million covered lives.

Centinel Spine recently announced significant expansion of coverage for lumbar TDR procedures in the Mid-Atlantic region of the U.S.

The policy expansion announced by New Jersey’s largest commercial payer—effective November 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 applies exclusively to the use of the prodisc L device.

Additionally, the largest commercial payer in the Philadelphia tri-state area has established positive coverage for both one- and two-level lumbar TDR. This policy expansion became effective October 20, 2024, and represents over 850,000 covered lives.

With this favorable coverage expansion in the Mid-Atlantic region, it is estimated that commercial coverage in the U.S. for one-level lumbar TDR has grown from 50% of covered lives in 2017 to nearly 95%* today. Commercial coverage in the U.S. for two-level lumbar TDR has made tremendous strides over the last two years, now with over 35% commercial coverage.

 

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

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