CMS clarifies coding and billing for NCTAP

CMS on January 27 updated coding and billing instructions to hospitals for new COVID-19 treatments add-on payment (NCTAP). The NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule with comment period (IFC-4) and is effective November 2, 2020 through the end of the public health emergency.

For treatments covered under the NCTAP, such as remdesivir, convalescent plasma, and baricitnid, hospitals should report the ICD-10-PCS codes for the products even if the products are acquired at no cost. However, if the products are acquired at no cost, hospitals should not report a charge.

The NCTAP is the lesser of:

• 65% of the operating outlier threshold for the claim
• 65% of the cost of a COVID-19 stay beyond the operating Medicare payment, including the 20% add-on payment under section 3710 of the the Coronavirus Aid, Relief, and Economic Security Act

Hospitals may refer to IFC-4 and CMS’ COVID-19 FAQs for more information.