|
|
.
2025B Ambulatory Payment Classification: 9487
Title: Ustekinumab, iv inject,1 mg
| 2025B Relative Weight: | 0 |
| 2025B Payment Rate: | $ 12.81 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 2.57 |
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 9487* |
| NPI | Organization | APC 9487 Submitted |
| 1568492916 |
INDIANA UNIVERSITY HEALTH NORTH HOSPITAL INC-INDIANAPOLIS-IN
|
XX
|
| 1548202641 |
BETH ISRAEL DEACONESS MEDICAL CENTER, INC.-BOSTON-MA
|
XX
|
| 1932208576 |
UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL-MORRISVILLE-NC
|
XX
|
| 1841266194 |
MAYO CLINIC HOSPITAL-ROCHESTER-ROCHESTER-MN
|
XX
|
| 1649794157 |
OU MEDICINE INC.-OKLAHOMA CITY-OK
|
XX
|
| 1689772592 |
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO-SAN FRANCISCO-CA
|
XX
|
| 1932103413 |
MOUNT SINAI HOSPITAL-NEW YORK-NY
|
XX
|
| 1487655064 |
BAYSTATE MEDICAL CENTER INC-SPRINGFIELD-MA
|
XX
|
| 1639172372 |
CEDARS-SINAI MEDICAL CENTER-LOS ANGELES-CA
|
XX
|
| 1790717650 |
BRIGHAM & WOMENS HOSPITAL, INC.-SOMERVILLE-MA
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J3358 Ustekinumab, iv inject, 1 mg
|
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.
|
|
