Medicare New Technology Add-on Payments
If you’re launching a new medical device that serves Medicare patients, securing New Technology Add-on payment from the Medicare program could mean the difference between adoption and inertia.
NTAP is a unique opportunity. It provides temporary, separate reimbursement under the Medicare inpatient hospital prospective payment system (IPPS) for new devices that meet certain criteria—before they’re bundled into DRG payment rates.
Unlike permanent DRG rates, NTAP offers time-limited, incremental payments that help hospitals cover the added cost of using innovative technologies. For many companies, NTAP can help bridge the gap between market clearance and long-term payment stability, making it a critical part of a launch strategy.
This early support encourages providers to adopt and gain experience with your product while CMS collects data to set future rates. Understanding the NTAP criteria, timelines, and application process can position your device for faster uptake, stronger clinical evidence generation, and a smoother path toward sustainable Medicare reimbursement.
WHAT IS MEDICARE NEW TECHNOLOGY ADD-ON PAYMENT?
The NTAP program helps hospitals receive additional reimbursement for innovative drugs, devices, and diagnostics that are new, costly, and show substantial clinical improvement over existing options. It provides up to 65% of the added cost (75% for certain infectious disease drugs) on top of the standard inpatient payment. To qualify, products must have FDA market authorization by May 1 of the year before the payment year. The program offers special pathways for breakthrough or antimicrobial products, giving early adopters of transformative technologies fairer payment under Medicare’s inpatient system.
NTAP CRITERIA
To qualify, a technology must be new, meaning it isn’t yet reflected in DRG payments or substantially similar to existing products; costly, meaning its hospital costs exceed CMS’s threshold; and show substantial clinical improvement by offering better outcomes, earlier diagnosis, or treatment for patients lacking good alternatives.
WHO CAN WE HELP?
We work with:
• Early-stage medtech companies preparing to launch
• Market access teams seeking Medicare strategy
• Investors performing reimbursement diligence
HOW CAN WE HELP?
Are you ready to apply for NTAP or do you want to learn more and need help deciding if it’s right for you?
Book a complimentary 30-minute consultation.
Our Expertise Shines
- Working with an experienced healthcare consultant with over 30 years of experience with the Medicare program provides you with a level of knowledge and skill unmatched in the industry.
- Our comprehensive understanding of Medicare payment helps avoid reimbursement disasters.
- Clients trust us to review their devices and help navigate through the Medicare NTAP process
Learn more on CMS’s New Technology Add-on Payment page.
FAQ
What is NTAP Payment?
A temporary Medicare add-on payment for new devices used in an inpatient hosptial that meet specific criteria: newness, cost, and clinical benefit.
How long does NTAP payment last?
NTAP payment lasts up to three years, after which the device becomes part of bundled DRG payment.
Who reviews NTAP applications?
CMS evaluates NTAP requests during the annual IPPS rulemaking cycle, typically finalizing decisions by April each year.
What is "substantial clinical improvement"?
It means your device offers meaningful benefits over existing treatments—like reduced complications, faster recovery, or improved quality of life.
Can I apply more than once?
Yes. CMS allows reapplications, and some previously denied products have been approved in later years with stronger evidence.
What's the alternative pathway?
If your device has Breakthrough Device designation, FDA Qualified Infectious Disease Product Designation (PDF) or approved under the FDA Limited Population Pathway for Antibacterial and Antifungal Drugs (LPAD pathway) you may bypass the clinical improvement requirement.
What do I do next?
Book a free 30 minute consultation and we can discuss your options. Visit the contact us page.
