Hospital Outpatient PPS
COVID-19: New HCPCS Code for Convalescent Plasma in Outpatient Setting
On December 28, the FDA revised the emergency use authorization for COVID-19 convalescent plasma with high titers of anti-SARS-CoV-2 antibodies. It’s authorized for treatment of COVID-19 in patients with immunosuppressive disease or getting immunosuppressive treatment, in the outpatient or inpatient setting.
CMS created HCPCS code C9507 for COVID-19 convalescent plasma for use in the outpatient setting, effective on or after December 28. For billing & payment information, see the April 2022 Addendum B on the OPPS Addendum A and Addendum B Updates webpage.
Hospital Outpatient Prospective Payment System Rulemaking
- Price Transparency of Hospital Standard Charges
- Beneficiary Protections
- Health Equity, Access to Emergency Care in Rural Areas, & Lessons from COVID-19
Some drugs and biologicals based on ASP methodology may have payment rates that are corrected retroactively. These retroactive corrections typically occur on a quarterly basis as a part of the OPPS payment system quarterly update change request. Beginning with the January 2015 OPPS payment system quarterly update change request, the list of drugs and biologicals with corrected payments rates, for a particular quarter, are accessible from the left menu link titled "Restated Drug and Biological Payment Rates".
For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) hospitals, go to the Hospital Center (see under "Related Links Inside CMS" below). Mailbox: email@example.com.
For files to order, see Limited Data Set Files - Hospital Outpatient Prospective Payment System and the Identifiable Data Files.