News Briefs: June 3, 2019

A May 28 MLN Matters (SE19009) on Medicare billing for Chimeric Antigen Receptor (CAR) T-Cell Therapy services replaces reporting instructions in the April 2019 update of the Hospital Outpatient Prospective Payment System (Transmittal 4255). CAR T is a form of immunotherapy that uses specially altered T cells to fight cancer. “Effective January 1, 2019, HOPDs may report CPT codes 0537T, 0538T, and 0539T to allow tracking of these services when furnished in the outpatient setting. Medicare will reject these lines as Medicare does not separately pay for these services under the OPPS,” CMS says. “For claims submitted on or after April 1, 2019, hospitals may report the CAR T-cell-related revenue codes 087X (Cell/Gene Therapy) and 089X (Pharmacy) established by the National Uniform Billing Committee. When billing charges separately for tracking these services when furnished in the outpatient setting, providers must submit: HCPCS 0537T with revenue code 0871; HCPCS 0538T with revenue code 0872; and HCPCS 0539T with revenue code 0873.” Visit https://go.cms.gov/2HMYOgL.

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