National Coverage Determination 110.24: Chimeric Antigen Receptor T-cell Therapy - Revised

MLN Matters Number: MM12928 Revised
Related CR Release Date: December 30, 2022
Related CR Transmittal Number: R11774CP
Related Change Request (CR) Number: 12928
Effective Date: January 1, 2022
Implementation Date: January 31, 2023

Note: CMS revised the Article to clarify that providers shouldn’t bill more than 1 unit per HCPCS code as shown in dark red on page 1.

CR 12928 tells you about:

  • Include additional place of service (POS) codes for office and independent clinics
  • Bill in 0.1-unit fractions
  • Don’t bill more than 1 unit per HCPCS code
  • Use 3 modifiers, including new modifier -LU

Make sure your billing staff knows about these changes for CAR T-cell Therapy (CAR-T) billing.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)12928.

Last Updated Jan 12 , 2023