National Coverage Determination (NCD 110.24): CAR T-cell Therapy - This CR Rescinds and Fully Replaces CR 11783 - Revised

MLN Matters Number: MM12177 Revised
Related CR Release Date: July 20, 2021
Related CR Transmittal Number: R10891CP and R10891NCD
Related Change Request (CR) Number: 12177
Effective Date: August 7, 2019
Implementation Date: September 20, 2021

Note: CMS revised the Article to add information on the use of the KX modifier on professional claims. You’ll find the substantive content update in dark red font on page 4. All other information is the same.

CR 12177 tells you that, effective for claims with dates of service on or after August 7, 2019, CMS covers autologous treatment for cancer with T-cells expressing at least 1 Chimeric Antigen Receptor (CAR) when administered at healthcare facilities:

  • Enrolled in the FDA Risk Evaluation and Mitigation Strategies (REMS)
  • Meets specified CMS/FDA criteria

View the complete CMS Medicare Learning Network (MLN) Matters (MM)12177.

            Last Updated Thu, 14 Oct 2021 15:13:19 +0000