CMS Expands NOPAIN Act Coverage, Boosting Avanos Medical's Pain Management Portfolio
Event summary
- CMS expanded the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act eligibility to include Avanos Medical’s Game Ready GRPro 2.1 system, effective January 1, 2026.
- The NOPAIN Act provides separate Medicare payment for qualifying non-opioid pain management drugs and devices, initially enacted in 2023.
- Avanos’ ON-Q and ambIT infusion pumps will continue to be eligible for separate payment under the NOPAIN Act.
- CMS has assigned a unique HCPCS code (C9817) for the Game Ready GRPro 2.1 system, with a payment limitation of $1,997.16.
- The ON-Q and ambIT systems have payment limitations of $2,008.72 each.
The big picture
The NOPAIN Act reflects a broader push to reduce opioid dependence and expand access to alternative pain management therapies. This expansion validates Avanos’ strategy of focusing on non-opioid solutions and positions the company to benefit from the ongoing shift in post-operative care. The CMS decision provides a degree of revenue certainty for Avanos, but the long-term success hinges on adoption rates and competitive pressures.
What we're watching
- Adoption Rate
- The speed at which hospitals and ASCs adopt the Game Ready system and incorporate it into their post-operative pain management protocols will determine the full financial impact for Avanos.
- Competitive Landscape
- How competitors respond to the expanded NOPAIN Act coverage and whether they develop alternative non-opioid pain management solutions will shape Avanos’ market share.
- Legislative Risk
- Future legislative or regulatory changes impacting the NOPAIN Act could alter reimbursement rates or eligibility criteria, creating uncertainty for Avanos’ revenue stream.
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