Expect a payment rate of $750.50 for this outpatient code.
Medicare announced a new HCPCS Level II code for COVID-19 convalescent plasma for use in the outpatient setting. The effective date is Dec. 28, 2021.
When to Use C9507
The effective date for C9507 Fresh frozen plasma, high titer COVID-19 convalescent, frozen within 8 hours of collection, each unit is based on the date the Food and Drug Administration (FDA) revised the emergency use authorization for COVID-19 convalescent plasma with high titers of anti-SARS-CoV-2 antibodies. SARS-CoV-2 is the virus that causes COVID-19. The plasma product is authorized for treatment of COVID-19 in patients with immunosuppressive disease or getting immunosuppressive treatment in the outpatient or inpatient setting.
Remember that C9507 is for use by outpatient facilities. The HCPCS Level II codes that begin with a C are used primarily by Outpatient Prospective Payment System (OPPS) hospitals to report new technology procedures, drugs, biologicals, radiopharmaceuticals, services, and devices that do not have other HCPCS Level II code assignments.
According to the Centers for Medicare & Medicaid Services’ (CMS’) Hospital OPPS webpage, outpatient facilities can use the information below when submitting claims for C9507:
> Ambulatory payment classification (APC): 1509 (New Technology – Level 9 ($701 – $800))
> Status indicator: S (Procedure or service, not discounted when multiple/Paid under OPPS; separate APC payment)
> Payment rate: $750.50
For more information, visit: https://www.aapc.com/blog/84028-code-c9507-for-convalescent-plasma/