CMS Issues Quarterly Update to ASC Payment System

CMS
has issued updated payment rates for selected separately payable drugs and
biologicals and provided rates and descriptors for newly created Level II HCPCS
codes for drugs and biologicals in its first quarterly update to the ASC payment system.

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In the update, CMS announced four new drugs separately payable under the payment system beginning April 1. They are:

  • Injection, doripenem, 10 mg (HCPCS code: C9241), with an April 2008 payment of $0.81
  • Injection, Von Willebrand Factor Complex, human, Ristocetin Cofactor (not otherwise specified), per I.U. VWF:RCO (HCPCS code: Q4096), with an April 2008 payment of $0.65
  • Injection, immune globulin (Privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg (HCPCS code: Q4097), with an April 2008 payment of $33.86
  • Injection, iron dextran, 50 mg (HCPCS code: Q4098), with an April 2008 payment of $11.49

The deletion of two drug codes was also announced in the update. These drugs are no longer payable by Medicare:

  • Injection, iron dextran 165, 50 mg (HCPCS code: J1751)
  • Injection, iron dextran 267, 50 mg (HCPCS code: J1752)

Just as CMS provides regular quarterly updates to the Hospital Outpatient Prospective Payment System, CMS will now issue quarterly updates to ASC payment rates for separately paid drugs and biologicals, beginning with this April update. CMS will also update the lists of covered surgical procedures and covered ancillary services to include any newly created HCPCS codes.

To download a zipped file which includes April 2008 ASC approved HCPCS codes and payment rates, click here.

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