Is there a new HCPCS code to report when convalescent plasma is administered in the outpatient setting?
Yes. CMS announced the creation of new HCPCS code, C9507, to report on outpatient claims for convalescent plasma treatment for COVID-19 patients with immunosuppressive challenges.
For your convenience, the long and short code descriptors for HCPCS C9507 are listed below:
- Long descriptor: Fresh frozen plasma, high titer COVID-19 convalescent, frozen within 8 hours of collection, each unit
- Short descriptor: COVID-19 convalescent plasma
HCPCS code C9507 is retroactively effective to December 28, 2021 to coincide with the date that the FDA expanded its emergency use authorization (EUA) for convalescent plasma to allow its use in the outpatient setting to treat COVID-19 patients with immunosuppressive disease or receiving immunosuppressive treatment. CMS has indicated that payment for C9507 will be $750.50.
Resources:
CMS MLN Connects dated 12/10/2022
https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2022-02-10-mlnc
CMS site for Hospital Outpatient PPS
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS
EUA Letter of Authorization
https://www.fda.gov/media/141477/download