LIVIT · reimbursement

The pay model

How a specialty pharmacy or provider bills LIVIT compliance & adherence monitoring — the patient journey, the per-patient CPT economics, and how therapy length drives billable months.

A first-time patient, end to end

Enroll & enable — at the specialty pharmacy, the pharmacist attaches LIVIT to the bottle and activates it (90-day device). → RTM set-up 98975
Ship — the device reaches the patient in ~2 days, already paired to the prescription.
Auto-start — the phone app detects LIVIT and begins tracking. → the 16-day data clock starts
Monitor — LIVIT flags under-dose, over-dose, vital abnormality, lost prescription, device damage, and refill-due. → the billable data
Engage — the pharmacist acts on alerts: message / call / video, adjust, refill. → treatment management 98980 / 98981 + MTM 99606
Renew or retire — after a 1 / 2 / 3-month supply the disposable device is discarded; re-enroll for the next fill.

What LIVIT flags

Under-doseOver-doseVital abnormalityPrescription lostDevice damagedRefill due

A simple pay model — per patient (illustrative)

When	CPT	What	Approx. Medicare avg
Once, at enroll	98975	RTM set-up & patient education	~$20
Each 30 days	98976 / 98977	Device supply (16+ days of data)	~$50
Each 30 days	98980	Treatment management — 20 min + interactive contact	~$48
≈ per active month			~$98

Over the enrollment

Supply length	Set-up	Monthly	≈ Total per patient
1 month	$20	$98 × 1	~$118
2 months	$20	$98 × 2	~$216
3 months (90-day device)	$20	$98 × 3	~$314

Optional per-month add-ons: extra management time 98981 (~$39), pharmacist MTM 99606 (~$50–75), or RPM for the patch vitals (~$98). Each enrollment is a fresh device, so the cycle repeats per fill. Full CPT detail →

Margin — detailed

Two parties earn on the same patient: LIVIT sells the device to the pharmacy, and the pharmacy bills the CPT codes. Anchored on the real 2018 numbers — $25 per device (covering the 3-month enrollment), with unit cost falling batch over batch.

Assumptions (2018, real)

Item	Whose	Assumption
Device unit cost — first batch (supply-chain run)	LIVIT cost	~$33 (3,000 units ≈ ~$100K)
Device unit cost — next batch	LIVIT cost	~$15
Device unit cost — at scale (target)	LIVIT cost	< ~$10
Device price to pharmacy	LIVIT revenue	$25 / device (covers 3 months)
Tech / server / data	LIVIT cost	company overhead, scales with volume
Pharmacist time (~20 min)	Pharmacy cost	~$20 / active month
CPT reimbursement	Pharmacy revenue	~$98 / active month

Shipping and pharmacist time are the pharmacy's costs, not LIVIT's.

LIVIT — device economics (cost fell batch over batch)

Stage	Unit cost	Sell price	Margin / device	× 3,000 units
First batch (supply-chain run)	~$33	$25	~−$8	~−$24K
Next batch	~$15	$25	~+$10	~+$30K
At scale (target)	<$10	$25	~+$15	~+$45K

The first 3,000-unit run was a supply-chain learning batch — not cost-optimized, so it sold below cost. The next batch already hit ~$15/device (profitable at $25), with <$10 the target at higher volume. The $25 price stays low on purpose — the value that justifies it is the recurring CPT reimbursement it unlocks.

Pharmacy — net per patient

Duration	CPT + set-up	− pharmacist	− device ($25)	≈ Net
1 month	~$118	−$20	−$25	~+$73
3 months (90-day)	~$314	−$60	−$25	~+$229
Chronic / year (4 devices)	~$1,256	−$240	−$100	~+$916

A cheap one-time $25 device (per 3-month fill) unlocks ~$98/month of billing while the patient is active. That margin drives adoption and compounds on chronic, engaged patients.

When each loses money

LIVIT — only the first supply-chain batch sold below cost; from the next batch (~$15/unit) the device makes ~$10–15 each.
The pharmacy — if the patient never activates, or drops before day 16, or management isn't documented, the ~$98 CPT can't be billed even though the $25 device was bought.
Both risks shrink with fast activation, the ~2-day shipment, and chronic patients.

Illustrative unit economics anchored on real 2018 numbers — substitute current costs and pricing. Reflects product unit economics, not company revenue or a projection. Not financial advice.

Top specialty prescriptions — and how long they bill

Billing is per active month, so therapy length is the multiplier. Most top specialty conditions are chronic — indefinite therapy means recurring monthly billing, year after year.

~$98

per active month

~$1,200

chronic oral patient / year

~$314

90-day course

~$294

curative Hep C course

Drug	Condition	Route	Typical duration	Billable months
Humira	RA / Crohn's / psoriasis	Injectable	Chronic, indefinite	~12 / yr, ongoing
Skyrizi	Psoriasis / PsA / Crohn's	Injectable	Chronic	~12 / yr
Stelara	Psoriasis / Crohn's / UC	Injectable	Chronic	~12 / yr
Dupixent	Atopic dermatitis / asthma	Injectable	Chronic	~12 / yr
Keytruda	Oncology (multiple)	IV infusion	Up to ~24 mo / until progression	up to ~24
Enbrel	RA / psoriasis	Injectable	Chronic	~12 / yr
Trikafta	Cystic fibrosis	Oral daily	Lifelong	~12 / yr, ongoing
Biktarvy	HIV	Oral daily	Lifelong	~12 / yr, ongoing
Ocrevus	Multiple sclerosis	IV (q6 mo)	Indefinite	ongoing
Imbruvica / Revlimid	CLL / myeloma (oral oncology)	Oral	Until progression (often years)	ongoing
Mavyret (contrast)	Hepatitis C	Oral	8–12 weeks (curative)	~2–3 only

LIVIT device fit: the pill-bottle load cell targets oral specialty meds (bold rows — Trikafta, Biktarvy, oral oncology, Hep C); the app + vitals layer extends adherence/RTM to injectables too. General clinical durations — they vary by patient, regimen, and response.

Illustrative reimbursement model only. Amounts are approximate 2025 Medicare national averages — not guaranteed payment; they vary by year, geographic locality, MAC, and payer, and who may bill (especially pharmacist RTM/RPM) is nuanced. This reflects what a specialty pharmacy / provider may bill, not company revenue or a projection. SharkDreams, Inc. is a prior venture and was the subject of an SEC matter (final judgment March 2025; record at sec.gov). Not billing, legal, or financial advice.