Тарифы CMS на продукты крови и трансфузиологические процедуры амбулаторным пациентам в 2013 году
Payments for Blood Products
As shown in Table 1, payments for some of the most frequently transfused blood products will decrease in 2013. For example, the payment for leukoreduced RBCs will fall from $198.90 in 2012 to $193.24 in 2013 and the rate for leukoreduced platelets, pheresis will drop from $538.84 to $511.27.
TABLE 1 BLOOD PRODUCTS
CPT/ HCPCS
Description
APC
2012 Payment Rate
2013 Payment Rate
$ Change
% Change
P9010
Whole blood for transfusion
0950
$190.76
$169.83
-$20.93
-10.97%
P9011
Blood split unit
0967
$117.35
$136.36
$19.01
16.20%
P9012
Cryoprecipitate each unit
0952
$82.78
$78.64
-$4.14
-5.00%
P9016
RBC leukocytes reduced
0954
$198.90
$193.24
-$5.66
-2.85%
P9017
Plasma 1 donor frz w/in 8 hr
9508
$79.87
$78.71
-$1.16
-1.45%
P9019
Platelets, each unit
0957
$89.77
$91.61
$1.84
2.05%
P9020
Platelet rich plasma unit
0958
$141.83
$175.62
$33.79
23.82%
P9021
Red blood cells unit
0959
$149.16
$151.79
$2.63
1.76%
P9022
Washed red blood cells unit
0960
$287.38
$296.39
$9.01
3.14%
P9023
Frozen plasma, pooled, sd
0949
$66.84
$72.23
$5.39
8.06%
P9031
Platelets leukocytes reduced
1013
$131.07
$118.34
-$12.73
-9.71%
P9032
Platelets, irradiated
9500
$128.42
$134.23
$5.81
4.52%
P9033
Platelets leukoreduced irrad
0968
$140.00
$156.45
$16.45
11.75%
P9034
Platelets, pheresis
9507
$442.14
$431.99
-$10.15
-2.30%
P9035
Platelet pheres leukoreduced
9501
$538.84
$511.27
-$27.57
-5.12%
P9036
Platelet pheresis irradiated
9502
$554.93
$675.77
$120.84
21.78%
P9037
Plate pheres leukoredu irrad
1019
$691.79
$674.16
-$17.63
-2.55%
P9038
RBC irradiated
9505
$198.98
$201.95
$2.97
1.49%
P9039
RBC deglycerolized
9504
$238.64
$479.74
$241.10
101.03%
P9040
RBC leukoreduced irradiated
0969
$261.22
$273.19
$11.97
4.58%
P9043
Plasma protein fract,5%,50ml
0956
$18.02
$20.31
$2.29
12.71%
P9044
Cryoprecipitatereducedplasma
1009
$74.37
$67.97
-$6.40
-8.61%
P9048
Plasmaprotein fract,5%,250ml
0966
$72.55
$47.16
-$25.39
-35.00%
P9050
Granulocytes, pheresis unit
9506
$1,340.65
$1,618.09
$277.44
20.69%
P9051
Blood, l/r, cmv-neg
1010
$188.55
$185.29
-$3.26
-1.73%
P9052
Platelets, hla-m, l/r, unit
1011
$803.05
$775.45
-$27.60
-3.44%
P9053
Plt, pher, l/r cmv-neg, irr
1020
$615.69
$660.47
$44.78
7.27%
P9054
Blood, l/r, froz/degly/wash
1016
$104.95
$122.44
$17.49
16.67%
P9055
Plt, aph/pher, l/r, cmv-neg
1017
$383.70
$336.54
-$47.16
-12.29%
P9056
Blood, l/r, irradiated
1018
$146.80
$175.91
$29.11
19.83%
P9057
RBC, frz/deg/wsh, l/r, irrad
1021
$448.82
$368.69
-$80.13
-17.85%
P9058
RBC, l/r, cmv-neg, irrad
1022
$305.97
$286.56
-$19.41
-6.34%
P9059
Plasma, frz between 8-24hour
0955
$72.82
$75.53
$2.71
3.72%
P9060
Fr frz plasma donor retested
9503
$80.95
$56.82
-$24.13
-29.81%
Payments for Transfusion, Apheresis and Bone Marrow/Stem Cell Procedures
As outlined in Table 2, payments for the majority of transfusion and stem cell collection and processing procedures will increase in 2013. The payment for APC 0111 (apheresis, RBC, platelets, etc. and harvest autologous stem cells) will increase from $816.59 in 2012 to $950.65 in 2013 and payment for APC 0112 (bone marrow collection, apheresis, adsorp/reinfuse, photopheresis, etc.) will rise from $2494.33 to $2888.70. AABB, along with other cellular therapy organizations, has expressed concerns in the past that CMS payments for such procedures fall notably below actual costs. Since the APC rates are based on hospital charges, it is critical that hospitals charge accurately for these procedures.
TABLE 2 TRANSFUSION, APHERESIS AND STEM CELL PROCEDURES
