In August 2024, Ekso Bionics collected the first Medicare payment for a personal exoskeleton. On October 1 of this year, Wandercraft bought the company, two weeks after launching its own home exoskeleton, Eve, in the United States. Eve balances itself, so an adult with a spinal cord injury can stand and walk with both hands free. Ekso spent two years with a Medicare payment level, an FDA-cleared home device and rehab clinics sending it candidates, and it was still sold. Wandercraft now has all three at a larger scale, and Ekso's record says none of them settles how many people end up walking in an Eve at home.
What Ekso already had
Ekso's 2024 claim, for its Indego Personal device, was paid at the $91,032 level Medicare set for billing code K1007, which took effect on April 1 that year. The company said other public programs and private payers could use the same code. It also started a program in which the rehab centers that already owned its clinic exoskeletons screened their own patients for a home device.
Wandercraft bought Ekso from ChronoScale Holdings, which owned it through a subsidiary, and neither side disclosed the price. The San Francisco Business Times reports that Ekso posted a string of losses and went through a reorganization in recent years, and that it struggled to sell its expensive systems. The coverage doesn't separate the clinic business from the home device or rank the reasons, so I won't either. The record shows only that the payment level and the clinic channel were both in place during those years.
The steps between interest and payment
Wandercraft's launch release lays out what has to happen before anyone gets paid for an Eve. A candidate first gets a clinical evaluation and a trial in the device. If the trial goes well, a physician writes the order. Wandercraft then fits and builds an Eve for that one person, and the user and a companion go through a training program with its team before delivery. Medicare covers qualifying devices under K1007 only when eligibility and medical necessity are documented, and Wandercraft has staffed an access team to handle the benefits, paperwork, financing and payer calls. The release gives no price for Eve.
A candidate can drop out at the evaluation, the trial, the physician's office, the paperwork or the training. K1007 sets what Medicare pays at the far end of that sequence, and it has no bearing on how many people start at the evaluation or how many finish with a device at home.
Where the candidates come from
Wandercraft's answer to the start of that sequence is reach. It says its Atalante X and Ekso's EksoNR, both clinic exoskeletons, stand and walk patients at more than 700 rehabilitation centers between them, and the two systems are cleared for stroke, spinal cord injury, multiple sclerosis and acquired brain injury. A therapist who already puts patients in a clinic exoskeleton is a natural first stop for a home-device evaluation, which is the logic Ekso's own screening program ran on. National Seating & Mobility, Wandercraft's exclusive Eve distributor with more than 180 locations, covers delivery.
Ekso ran that logic with a smaller footprint. More clinics put more patients in front of an evaluation. They don't change what fraction of those patients come out the other end with a paid device, and that fraction is the number nobody has published.
Count your own steps
Two figures will show whether Eve is a business: the weeks between a first evaluation and a delivery, and the share of evaluations that end in a paid one. Wandercraft hasn't published either. Its research covers part of one step. In a peer-reviewed study, 15 of the first 16 participants who completed its training protocol met the study's goal for putting the device on after four training sessions, and all 16 met the goal for taking it off. Those are people who finished the protocol, so the study can't say how many dropped out before the end.
Founders selling a hospital capital purchase or a defense program face a sequence like Eve's. The surgeon's yes goes to a value analysis committee, and a system that passes its tests still needs a contract award. Either kind of founder can pull each step's conversion from their own pipeline records, and the step that loses the most candidates is where product work earns the most: for Eve, that could be a shorter trial protocol, fewer training sessions for a companion, or documentation ready before the physician asks for it.
Dave's take
Buying a competitor with its clinic customers is the fast way to get more people in the door, and Wandercraft did it in a single deal. Getting them out the other side with a device at home is slower work, done one trial protocol and one documentation packet at a time, and that's the work I want to see the numbers on.
From Dave’s video library
In tonight's Robot Roundup, Dave walks through Eve's path from a first evaluation to a Medicare-paid delivery, and what Ekso's two years under the same billing code suggest.
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Dave Saunders is the founder of Base Reality Group and a Fractional CPO for product companies. He was a founder and operator at Galen Robotics, where the surgical-robotics platform earned FDA De Novo authorization in 2023, and he managed a 35-patent portfolio licensed from Johns Hopkins. He wrote Founders Who Finish and publishes The Build. More about Dave →