Analyst Ratings January 22, 2026

Oppenheimer Revises Inspire Medical Rating After Medicare Reimbursement Shift

CMS reversal prompts downgrade amid concerns over revenue impact and pricing uncertainties

By Hana Yamamoto INSP
Oppenheimer Revises Inspire Medical Rating After Medicare Reimbursement Shift
INSP

Oppenheimer has adjusted its rating on Inspire Medical Systems from Outperform to Perform following a reversal by the Centers for Medicare & Medicaid Services (CMS) regarding reimbursement coverage for Obstructive Sleep Apnea. The change tempers expectations for revenue boosts linked to facility fees and average selling price adjustments, despite the company's strong cash position and recent sales growth.

Key Points

  • Oppenheimer downgraded Inspire Medical Systems from Outperform to Perform following CMS reimbursement reversal.
  • CMS corrected its prior inclusion of Obstructive Sleep Apnea coverage under vagus nerve stimulation NCD, removing anticipated financial benefits.
  • Inspire Medical’s strong liquidity and recent sales growth mitigate, but do not eliminate, concerns arising from reimbursement changes.

Oppenheimer downgraded its stock rating for Inspire Medical Systems (NYSE: INSP) on Thursday, moving from an Outperform classification to Perform. This decision follows a correction issued by the Centers for Medicare & Medicaid Services (CMS) which rescinded a prior reimbursement inclusion for Obstructive Sleep Apnea under the vagus nerve stimulation national coverage determination (NCD).

The CMS notification indicated that the agency had "incorrectly added Obstructive Sleep Apnea as a covered indication under the vagus nerve stimulation NCD." This reversal negates the previous assumption that Inspire Medical would benefit from expanded reimbursement, posing financial headwinds for the company.

Analysis from InvestingPro suggests that despite the recent downgrade and regulatory changes, Inspire Medical is undervalued relative to its Fair Value, supported by a comprehensive set of 14 ProTips that address elements such as cash flow strength and earnings outlook.

The downgrade by Oppenheimer emphasizes several negative impacts from the CMS correction. These include the loss of anticipated facility fee increases and reduced possibilities for average selling price pass-through, both of which were expected to enhance financial performance. Nonetheless, Inspire Medical continues to maintain a favorable financial structure; its balance sheet shows more cash than debt and liquid assets exceeding short-term liabilities.

Furthermore, billing under CPT code 64582 combined with modifier 52 is anticipated by Oppenheimer to deliver a "net negative" effect on the company’s revenues. Additional concerns include expected downward pressure on inventory sales and the dynamics surrounding new site openings.

The research firm conceded that the timing of its prior upgrade was unfortunate, given the CMS reimbursement reversal, and recommended that Inspire Medical reassess its financial guidance for fiscal year 2026 in response to these regulatory developments.

Separately, Inspire Medical Systems recently announced preliminary fourth-quarter sales approximately totaling $269 million, representing a 12% increase year-over-year and exceeding consensus estimates of $262 million. This strong sales performance has led Jefferies to raise its price target to $100 while maintaining a Hold rating.

Conversely, Truist Securities reduced its price target to $120, citing uncertainties in pricing strategies for 2026 stemming from disagreements between regional Medicare Administrative Contractors (MACs) and CMS.

Notably, Oppenheimer has maintained an Outperform rating and a $175 price target following updates related to policies from Medicare Administrative Contractors, indicating divergent views within the analyst community.

In corporate developments, Inspire Medical Systems announced Matt Osberg as the incoming Executive Vice President and Chief Financial Officer, effective January 19, 2026. Osberg brings over twenty years of financial leadership experience from his previous roles at Apogee Enterprises and Best Buy.

Additionally, Impulse Dynamics named Richard J. Buchholz as CFO effective March 2, 2026. Buchholz formerly served as CFO at Inspire Medical Systems and played a pivotal role in the company's path to profitability.

Risks

  • Revenue and earnings pressures due to CMS revocation of Obstructive Sleep Apnea coverage impact Inspire Medical's pricing and reimbursement strategies.
  • Billing adjustments involving CPT 64582 with modifier 52 expected to negatively affect net financial results.
  • Uncertainty in 2026 pricing and reimbursement policies caused by disagreements between regional Medicare Administrative Contractors and CMS introduce forecast volatility.

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