Inspire(US:INSP)2026-02-11 23:02Financial Data and Key Metrics Changes - Fourth quarter revenue increased by 12% to $269 million, and full year revenue increased by 14% to $912 million, primarily driven by growth at existing centers and new center additions [18][19] - Fourth quarter net income per diluted share increased from $3.51 to $4.66, while full year net income per diluted share increased from $3.09 to $4.89 [18] - Fourth quarter operating cash flow was $52 million, bringing the full year total to $117 million [19] Business Line Data and Key Metrics Changes - The Inspire V system demonstrated superiority over Inspire IV, with a 79.5% responder rate in the Singapore study compared to 66% in the STAR phase III pivotal trial [11] - CPT code 64568 was used for approximately 10,000 Inspire V procedures in 2025, providing a basis for professional reimbursement [9] Market Data and Key Metrics Changes - The company is revising its full year revenue outlook for 2026 to a range of $950 million to $1 billion, reflecting expected impacts from coding uncertainty and physician reimbursement rates [20] - The company anticipates a net loss in the first quarter of 2026 due to revenue expectations and higher operating expenses [23] Company Strategy and Development Direction - The company is focused on developing a new CPT code for the Inspire V procedure, as the current -52 modifier is not seen as a long-term solution [31][82] - The company plans to enhance patient access to Inspire therapy by training advanced practice providers and certifying additional surgeons [16] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the Inspire V system's effectiveness and the ability to work with payers to minimize reimbursement reductions [104] - The company is addressing challenges related to the WISeR program, which requires prior authorizations for Medicare cases in six pilot states [15][37] Other Important Information - The company completed $50 million of share repurchases in the fourth quarter, bringing the full year total to $175 million [19] - The company is nearing completion of manufacturing the Inspire IV systems but has sufficient inventory for centers that may choose to continue using them [9] Q&A Session Summary Question: Clarity on physician fee with Gen 5 using the 82 code and -52 modifier - Management indicated that existing policies must be followed and that they are working with MACs and commercial payers to drive consistency in reimbursement [28][29] Question: Pathway forward for Gen 5 and pursuing a dedicated code - Management confirmed they are pursuing a new CPT code and have inventory of Inspire IV available for physicians who wish to continue using it [32] Question: Impact of the WISeR program on revenue guidance - Management clarified that the primary reason for revenue reduction is coding uncertainty, while the WISeR program is causing some disruption [37] Question: Pricing strategy in light of reimbursement changes - Management stated that they expect consistent product pricing going forward, aligning with the current pricing model [60] Question: Clarification on coding and competition - Management emphasized confidence in their technology and the Inspire V system's strong safety profile, while acknowledging some impact from competition [68] Question: Expectations for commercial payers and billing practices - Management noted that commercial payers currently allow billing under 64568, but they expect a transition to 64582 with the -52 modifier over time [72]