Beginning January 1, 2021, the cinacalcet oral drug is eligible for consideration as an ESRD outlier service:

• Report the number of tablets or pills, not the number of units (for example, milligrams)
• Report revenue code 250 with the national drug code
• Don’t use revenue code 0636 with HCPCS code J0604

More Information:

• MLN Matters Article MM12011 (PDF), page 7
• ESRD PPS Outlier Services webpage
• Medicare Benefit Policy Manual, Chapter 11 (PDF), §20.3.C
• Medicare Claims Processing Manual, Chapter 8 (PDF), §60.2.1.2

Source: CMS MLN Connects dated September 23, 2021