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2025B Ambulatory Payment Classification: 1468
Title: Inj, abilify maintena, 1 mg
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 7.03 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 1.41 |
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 1468* |
| NPI | Organization | APC 1468 Submitted |
| 1053358945 |
CAROLINAS MEDICAL CENTER-CHARLOTTE-NC
|
XXX
|
| 1376544320 |
STATE UNIVERSITY OF IOWA-IOWA CITY-IA
|
XXX
|
| 1124032982 |
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION-NEW YORK-NY
|
XXX
|
| 1811977796 |
ST. MARY'S HEALTHCARE-AMSTERDAM-NY
|
XXX
|
| 1336366822 |
THE UNITY HOSPITAL OF ROCHESTER-ROCHESTER-NY
|
XX
|
| 1467595793 |
TRUMAN MEDICAL CENTER, INCORPORATED-KANSAS CITY-MO
|
XX
|
| 1043267727 |
SAMARITAN HOSPITAL OF TROY, NEW YORK-ALBANY-NY
|
XX
|
| 1760436216 |
MAINEHEALTH-PORTLAND-ME
|
XX
|
| 1396882205 |
VANDERBILT UNIVERSITY MEDICAL CENTER-NASHVILLE-TN
|
XX
|
| 1417027558 |
BRONXCARE HEALTH SYSTEM-BRONX-NY
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J0401 Inj, abilify maintena, 1 mg
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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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