Billing Instructions for Beneficiaries Enrolled in Medicare Advantage (MA) Plans for Services Covered by Decision Memo CAG-00451N
This article conveys information on the National Coverage Determination (NCD) requiring coverage of Chimeric Antigen Receptor (CAR) T-cell therapy for cancer. For more information on the National Coverage Determination, see the decision memorandum at https://www.cms.gov/medicare-coverage-database/details/ncadecision-memo.aspx?NCAId=291. The Centers for Medicare & Medicaid Services (CMS) is providing this information for hospitals providing CAR T-cell therapy to beneficiaries enrolled in Medicare Advantage (MA) plans. Make sure your billing staff is aware of these instructions.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 24, 2019
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.