top of page

Michael A. Sanchez, M.A., CCA

Founder and Principal Advisor

Mike is an experienced reimbursement consultant who specializes in providing strategic assessment and planning and tactical support to medical device clients across all payer and provider types. With over 20 years of experience working for medical device companies, he is knowledgeable in supporting cardiac, peripheral vascular, neuromodulation, orthopedic and various other FDA Class II/III medical device technologies. Additional expertise includes helping medical device companies navigate Medicare’s complex requirements for appropriate coverage, coding and payment in Category A/B Investigational Device Exemption (IDE) studies to help ensure timely enrollments in industry-sponsored clinical trials. Mike is also a veteran of the U.S. Air Force, holds a Master’s degree from the College of St. Scholastica, and is a Certified Coding Associate (CCA) through the American Health Information Management Association (AHIMA).

Pivotal Reimbursement


Office Location

Saint Paul, MN

Useful Links


FDA/HCFA Interagency Agreement (1995)

FDA FAQs IDE Reimbursement

FDA Info - Charging for Investigational Products

Health Plan Policy Search

LifeScience Alley

MedPac Payment Basics

Medical Device Manufacturers Assoc

TRICARE Fee Schedule Search

Medicare Shortcuts

Accountable Care Organizations (ACO)

Clinical Laboratory Fee Schedule (CLAB)

CMS Central IDE Coverage & Review

Clinical Trial Policy NCD

Competitive Bidding Program

Coverage Center

DMEPOS Fee Schedule Search

Innovator's Guide

Medicare Learning Network (MLN)

Physician Fee Schedule (PFS) Search


Copyright Pivotal Reimbursement Consulting 2017

bottom of page