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2025B Ambulatory Payment Classification: 1064
Title: I131 iodide cap, rx
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 23.13 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 4.63 |
Addendum D1 Information
Status Indicator: K
Item / Code / Service:
(1) Non-Pass-Through Drugs and Biologicals
(2) Therapeutic Radiopharmaceuticals
(3) Brachytherapy Sources
(4) Blood and Blood Products
OPPS Payment Status:
(1) Paid under OPPS; Separate APC payment.
(2) Paid under OPPS; Separate APC payment.
(3) Paid under OPPS; Separate APC payment.
(4) Paid under OPPS; Separate APC payment.
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| 2021 Top 10 OPPS Facility Claims for APC 1064* |
| NPI | Organization | APC 1064 Submitted |
| 1649299827 |
BARNES JEWISH HOSPITAL-SAINT LOUIS-MO
|
XX
|
| 1366459570 |
NORTH SHORE UNIVERSITY HOSPITAL-WESTBURY-NY
|
XX
|
| 1548387418 |
THE METHODIST HOSPITAL-HOUSTON-TX
|
XX
|
| 1548378235 |
MEDSTAR WASHINGTON HOSPITAL CENTER-WASHINGTON-DC
|
XX
|
| 1154317527 |
STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER-CLINTON-MS
|
XX
|
| 1649278730 |
UPMC ALTOONA-PITTSBURGH-PA
|
XX
|
| 1679578439 |
MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER-TYLER-TX
|
XX
|
| 1639172372 |
CEDARS-SINAI MEDICAL CENTER-LOS ANGELES-CA
|
XX
|
| 1841266194 |
MAYO CLINIC HOSPITAL-ROCHESTER-ROCHESTER-MN
|
XX
|
| 1780653618 |
H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.-TAMPA-FL
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
A9517 I131 iodide cap, rx
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Sources: Updates of Addendum A and B are posted quarterly to the OPPS website. These addenda are a "snapshot" of HCPCS codes and their status indicators,
APC groups, and OPPS payment rates, that are in effect at the beginning of each quarter. The quarterly updates of Addendum A and Addendum B reflect
the OPPS Pricer changes that are part of the quarterly OPPS recurring update notification transmittals.
http://www.cms.gov/HospitalOutpatientPPS/AU/list.asp#TopOfPage
For more information on the Composite APC payment,
please see CMS Transmittal R2141CP.
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