WEST CHESTER, PA — Centinel Spine®, LLC has announced a major expansion in insurance coverage for lumbar total disc replacement (TDR) procedures in the Mid-Atlantic region, marking a significant advancement in spine care access. This expansion follows policy updates from the largest commercial insurers in both New Jersey and the Philadelphia tri-state area.
In New Jersey, the state’s leading commercial insurer, covering over 2.3 million people, has broadened its approval to include both one- and two-level lumbar TDR procedures. This change, effective November 1, 2024, supports the use of Centinel Spine’s prodisc® L, the sole lumbar TDR system in the U.S. approved for both one- and two-level applications.
Similarly, the top insurer in the Philadelphia tri-state area, which provides coverage to over 850,000 individuals, has also started offering positive coverage for these procedures as of October 20, 2024. This policy change is expected to significantly boost access to lumbar TDR in the region.
The expansion means that coverage for one-level lumbar TDR is now estimated to reach nearly 95% of commercially insured individuals in the U.S., a dramatic rise from just 50% in 2017. Coverage for two-level procedures has also grown, now covering over 35% of the commercially insured population.
Steve Murray, CEO of Centinel Spine, expressed optimism about the developments. “It’s encouraging to see the top commercial payers in the Philadelphia and New Jersey areas provide much needed one- and two-level lumbar total disc replacement access to a significant number of individuals,” he stated. “Commercial coverage for one-level lumbar disc procedures is close to universal at this point. And we are further encouraged by the nationwide acceleration of coverage for two-level lumbar disc replacement procedures as it was essentially non-existent several years ago.”
Murray emphasized the advantages of lumbar TDR, noting, “The long-term safety and clinical benefits of lumbar total disc replacement are indisputable, and the procedure is an excellent option for many patients. We are inspired by the continually improving environment we see for total disc replacement in spine care.”
This expanded coverage by major insurers highlights a growing recognition of the benefits of TDR, offering patients more options for effective spine care.
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