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REIMBURSEMENT UPDATE

New Hospital Cost Center for Reporting Allogeneic HCT Cell Aquisition 

CMS has released new instructions for reporting acquisition costs associated with allogeneic HCT on the annual cost report:

Line 77--Effective for services rendered on or after January 1, 2017, enter the hospital acquisition costs for allogeneic stem cell transplants (when stem cells are obtained from a donor rather than from the recipient) as defined in CMS Pub. 100-04, chapter 4, §231.11. Do not include costs for autologous transplants (when transplanted stem cells are obtained from the recipient (CMS Pub. 100-04, chapter 4, §231.10)).

Line 77, specific to allogeneic cell acquisition, is found on the hospital cost report form CMS-2552-10 and replaces line 112 (other organ acquisition) as the cost center for reporting all donor search and cell acquisition costs associated with revenue code 0815. Addition of cost center 77 will allow CMS to more accurately capture acquisition costs specific to allogeneic HCT.

Download Medicare Reimbursement Manual Chapter 40 (T13) – Hospital & Hospital Health Care (Form CMS-2552-10)


Choosing Wisely Top 5 Recommendations for HCT

The American Society for Blood and Marrow Transplantation and the Canadian Blood and Marrow Transplant Group joined together to release five recommendations for the Choosing Wisely initiative of the American Board of Internal Medicine (ABIM) Foundation. Choosing Wisely recommendations were created to “spark conversations between providers and patients” in an effort to promote transparency and engagement.

Read about the Choosing Wisely Top 5 for HCT.

Learn more about Choosing Wisely.


Ask Members of Congress to Protect Access to Transplant

We are still working very hard on getting H.R. 4215 passed, and we still need your support. Please Take Action by asking your Members of Congress to support H.R. 4215.  This legislation would require the CMS to pay for cell acquisition on a reasonable cost basis and separately from the payment for the transplant hospital stay. The current payment of approximately $65,000 inadequately covers both cell acquisition and the transplant hospital stay. While there is not yet a Senate companion bill to H.R. 4215, it is still important to let your Senators know how important it is that they fix this payment issue before the April release of the Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule. Your support of H.R. 4215 ensures that Medicare beneficiaries continue to have access to life-saving transplant.


2018 BMT Tandem Meetings Highlight - CMS Super Session  

If you are attending the BMT Tandem Meeting this year in Salt Lake City, don’t forget to add the CMS Super Session to your meeting schedule. This session, part of the Administrative Director’s Conference track, will provide need-to-know updates on Medicare coverage, clinical trials, cost center reporting, and legislative efforts to improve reimbursement. And be sure to pick up new billing and coding resources! Mark your calendar: Thursday, February 22, 2018 from 10:30 a.m. – 12 noon (MST) in Room 251, Salt Palace Convention Center.


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If you have any questions or need additional information, please contact the Payer Policy Team at PayerPolicy@nmdp.org. All of our resources are available on our website: Network.BeTheMatchClinical.org/Reimbursement.

New hospital cost center for reporting allogeneic HCT cell acquisition

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