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2025B Ambulatory Payment Classification: 9359
Title: Inj crizanlizumab-tmca 5mg
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $129.50 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 25.91 |
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.
|
| 2021 Top 10 OPPS Facility Claims for APC 9359* |
| NPI | Organization | APC 9359 Submitted |
| 1144228487 |
SAINT FRANCIS HOSPITAL, INC.-TULSA-OK
|
XXX
|
| 1154435824 |
UNIVERSITY OF ALABAMA AT BIRMINGHAM-BIRMINGHAM-AL
|
XXX
|
| 1366436123 |
OUR LADY OF THE LAKE HOSPITAL INC.-BATON ROUGE-LA
|
XXX
|
| 1851333686 |
DANA-FARBER CANCER INSTITUTE, INC.-BOSTON-MA
|
XX
|
| 1669466561 |
STATE OF CONNECTICUT-FARMINGTON-CT
|
XX
|
| 1457396079 |
NORTHSIDE HOSPITAL, INC.-ATLANTA-GA
|
XX
|
| 1063489342 |
THE PENNSYLVANIA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA HEALTH SYS-PHILADELPHIA-PA
|
XX
|
| 1053360651 |
EAST BATON ROUGE MEDICAL CENTER LLC-BATON ROUGE-LA
|
XX
|
| 1679660617 |
UNIVERSITY OF MIAMI HOSPITAL AND CLINICS-MIAMI-FL
|
XX
|
| 1073688354 |
MIAMI VALLEY HOSPITAL-DAYTON-OH
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J0791 Inj crizanlizumab-tmca 5mg
|
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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