Centers for Medicare & Medicaid Services (CMS). Medicare program hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and policy changes and fiscal year 2020 rates quality reporting requirements for specific providers Medicare and Medicaid promoting interoperability programs requirements for eligible hospitals and critical access hospitals.

Medicare program hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and policy changes and fiscal year 2022 rates quality programs and Medicare promoting interoperability program requirements for eligible hospitals and critical access hospitals changes to Medicaid provider enrollment and changes to the Medicare shared savings program. Boston, MA: Alexion Pharmaceuticals, Inc. ANDEXXA ® (coagulation factor Xa (recombinant), inactivated-zhzo).

Effective July 1, 2020, the CMS has granted ANDEXXA its permanent J-code, facilitating reimbursement in all hospital outpatient departments and freestanding emergency facilities in the United States 7ġ.

Standardized code for ANDEXXA insurance claims across Medicare, Medicare Advantage, Medicaid, and commercial plans Hospitals not reimbursed under the Inpatient Prospective Payment Systems are not eligible to receive add-on payments. 6‡Įligibility to receive add-on-payments may vary. Many plans follow Medicare reimbursement guidance. 3,5 Commercial reimbursementĬommercial health plan reimbursement may vary.

†NTAP reimbursement for this product has been renewed until September 30, 2022. Centers for Medicare & Medicaid Services (CMS) increased NTAPs in fiscal year 2020 to promote patient access and reimbursement confidence for “new” and “transformative technologies.” An NTAP provides additional payment to hospitals above the standard MS-DRG payment amount. Medicare coverage is available for ANDEXXA.

Medicare new technology add-on payment (NTAP)

Andexxa price