AVITA Medical Announces National Medicare Physician Payment Framework and Simplified Billing Codes for RECELL Procedures in 2027

(NASDAQ:RCEL, ASX:AVH) AVITA Medical, Inc. announced that the Centers for Medicare & Medicaid Services (CMS) has finalized national physician valuations for skin cell suspension autograft (SCSA) procedures performed using RECELL® under the Calendar Year 2027 Medicare Physician Fee Schedule. Effective January 1, 2027, nationally published Relative Value Units (RVUs) will replace valuations set by regional Medicare Administrative Contractors (MACs). CMS is implementing a simplified family of four Current Procedural Terminology (CPT) billing codes to replace the current eight-code structure for SCSA procedures. These changes are intended to simplify procedure reporting and provide physicians with a clearer, more consistent basis for understanding Medicare payment when treating patients with burns and other serious skin injuries. Cary Vance, President and Chief Executive Officer of AVITA Medical, stated that these changes bring simpler billing and greater payment predictability to physicians using RECELL and strengthen the foundation for broader adoption of RECELL as a standard of care. The new Category I CPT code family combines reporting for skin harvesting, cell preparation, and application into a single, bundled SCSA procedure structure. Four codes will now replace the existing eight-code family, simplifying reporting of treatment steps. Codes will distinguish the body area treated and report treatment in increments of 100 square centimeters, with percentage-of-body-area reporting for infants and children. The new structure removes separate coding distinctions for manual and automated cell preparation. CMS-published RVUs will provide a common national basis for calculating Medicare physician payment, replacing regionally determined MAC valuations. In the inpatient setting, Medicare pays hospitals for cases involving RECELL through the Medicare Severity Diagnosis-Related Group (MS-DRG) system, with the RECELL System included among the resources used to treat the patient, and physicians receiving separate payment for their professional services. CMS has finalized facility payment assignments and rates for the new SCSA code family in both hospital outpatient and ambulatory surgery center (ASC) settings. The new physician valuations establish the basis for Medicare payment to physicians for professional services associated with SCSA procedures performed using RECELL, separate from facility payments to hospitals and ASCs. Medicare coverage policies continue to apply. CMS adopted the physician work RVUs recommended by the American Medical Association/Specialty Society RVS Update Committee without modification. For trunk, arms, and/or legs, the initial 100 square centimeters or less is assigned an RVU of 10.97, and each additional 100 square centimeters or part thereof is assigned an RVU of 0.59. For specified areas including the face, scalp, neck, hands and feet and/or fingers and toes, the initial 100 square centimeters or less is assigned an RVU of 11.28, and each additional 100 square centimeters or part thereof is assigned an RVU of 0.98. For infants and children, the codes also provide for reporting based on 1% of body area and additional 1% increments as applicable. The new SCSA code family takes effect January 1, 2027. In international markets, RECELL is approved to promote skin healing in a wide range of applications, including thermal burn and trauma wounds. RECELL and RECELL GO® are CE-marked in Europe, have TGA certification in Australia, and are listed with Medsafe in New Zealand; RECELL is PMDA-approved in Japan.