Reimbursement decides whether your product gets adopted
It is often one of a few make-or-break outcomes in a company's business plan. Current options prioritize hourly billing rates and timelines measured in months.
Is there a code, and is it the right one?
CPT and HCPCS mapping, including G-codes and J-codes, Category III realities, code histories, and what the pathway to a Category I code would take. We tell you which code strategy fits your evidence and your timeline.
Will payers pay for it?
Medicare, MAC, and commercial policy positions, payer by payer, with the evidence gaps that stand between you and a favorable policy. This work is often overlooked, but critically important.
What will you actually collect?
How much is the payment for your procedure? Fee schedules, site-of-service economics, and realized payment from claims data alongside the published allowable. Policy and payment often conflict; we quantify both.
Audit-grade evidence, at a pace the industry does not offer
Traditional firms staff your question with analysts and bill you for the hours. We built software that automates the research, then wrapped it in a quality architecture most firms reserve for regulatory submissions. Every factual claim is logged in a ledger, an adversarial verifier attacks the draft before you see it, and leading experts in the field help you turn the data into decisions and results.
A typical landscape ledger holds more than 70 verified claims, each linked to its source. Kickoff to deliverable takes days, on a pipeline instead of an associate army. No unverified claim ships, because every deliverable passes lint gating and then expert review. Every price is published, with fixed fees that are transparent and perfect for budget planning.
From a sample landscape for a fictional device. Hover over or tap a numbered fact to see its ledger entry.
Four Medicare contractors published a rate for code 0X12T in January 20261, and monthly claims rose from about 20 to more than 2002. Florida Blue pays 78% of claims without a written policy3, while UnitedHealthcare classifies the procedure as unproven and pays 9%4. The next step is a reconsideration request to UnitedHealthcare built on the Florida Blue payment record.
1 L-0046Fee schedules for Novitas JH and JL, WPS J5, and First Coast JN, January 2026. Checked 6 October 2026 against each contractor's posted file.
2 L-0118Computed from the claims extract (April 2025 to September 2026) and re-derived by a second, independent pass.
3 L-0124Computed from Florida Blue remittances. Its medical policy library was searched on 6 October 2026 and holds no policy for the procedure.
4 L-0083UnitedHealthcare Medical Policy, reviewed 1 March 2026, with the paid share computed from the claims extract.
Built for the companies the big firms overlook
Praxa works with medical device and life science companies from late seed through small public, plus the investors who back them. If you have any uncertainty, big or small, in your business plan around market access, you are our client profile.
Don't wait until you've secured your FDA milestone to start thinking about market access.
Founders and market access leaders hire us when they need a defensible answer fast, before a board meeting, a fundraise, a payer meeting, or a launch decision.
Full transparency
Defined deliverables, timelines, and prices you can see before we ever get on a call. Every product runs expert-in-the-loop. The platform does the research and a senior market access partner shapes and reviews the result.
The complete coding, coverage, and payment picture for your product, delivered as a verified claims ledger rendered into an interactive landscape and executive deck, with a senior market access expert shaping the strategy and reviewing the findings with your team.
$8,000fixed fee
Your landscape as a living document. A monthly change memo, alerts when a policy, code, or rate moves, and a quarterly re-verification of every claim against its source, each with an expert's read on what the change means for your product.
From $1,500 / monthper product
Utilization curves, realized payment vs. allowable, denial patterns, and growth inflections, built from remittance and claims data and interpreted by experts who can turn the findings into actionable next steps.
From $5,000plus data at cost
A simulated panel of payer medical directors, built from real coverage decisions and backtested for fidelity, that pressure-tests your evidence before real payers do. Experts who have sat across from those medical directors design the questions and interpret the answers. Planning a live medical director panel? Start here to prepare and get the most out of your live panel.
$10,000for three payers, $2,500 per additional persona
Per-payer evidence gap analysis, payer letters, and the reconsideration or coverage dossier that closes the gap, each drafted against the payer's own criteria and reviewed by senior market access experts before it reaches the payer.
From $3,000gap analysis, letters, dossiers
Reimbursement diligence for medtech investments, with risk-rated findings framed as deal questions, delivered inside a transaction timeline, and an expert's judgment on which risks are priced in and which are not.
$7,500flat, under a week
I've sat in your seat
I founded Praxa after co-founding and leading a venture-backed medical device company for nearly a decade as CEO, from prototype through FDA clearance to commercialization. I lived the coverage problem from the operator's chair, and I built Praxa to answer it the way I needed it answered then, which was fast, verified, and priced for a company that size.
Every engagement pairs my operator's read with senior market access expertise. After evaluating the needs of the project, we bring on a market access expert who will best fit your particular situation. The result is work that answers the needs of both the board and the payer.
Ryan Shelton, PhD
Founder. Former medtech CEO.
Current thinking
| Document | Brief | Topic |
|---|---|---|
| PRX-BRF-004 | Don't wait for the FDA milestone to start on market access.Coding, coverage, and payment run on calendars that start before clearance and close on their own schedule. What to do before submission, during review, and at clearance. | Strategy |
| PRX-BRF-002 | Your market access landscape was stale the day it arrived.Policies, rates, and codes move quarterly. A snapshot deliverable cannot keep up. What a living, re-verified evidence ledger looks like in practice. | Method |
| PRX-BRF-001 | RAPID replaced TCET. Most device companies have not caught up.CMS paused TCET in April and pointed Breakthrough devices at RAPID. What changed, who qualifies, and what to do before your competitors re-read the rule. | Policy |
We'd love to hear more about your innovation
Spend 30 minutes with me to learn more.