Centres for Medicare & Medicaid Services (CMS) has given permanent Healthcare Common Procedure Coding System (HCPCS) Level II codes for pathogen-reduced platelet and plasma components. Currently, Cerus’ (NASDAQ:CERS) INTERCEPT Blood System is the only FDA-approved system for pathogen reduction of platelet and plasma components, intended to reduce the risk of transfusion transmitted infections.

“The proportion of platelets transfused by hospitals on an outpatient basis is significant today, and continues to grow. These new billing codes now allow hospitals to bill and secure reimbursement for INTERCEPT-treated platelet and plasma components in this setting,” commented William “Obi” Greenman, Cerus’ president and chief executive officer. “Notably, the rate for a pathogen-reduced platelet unit represents a premium of $153.56 over the rate of $488.29 for a unit of conventional apheresis platelets. We were pleased to see strong advocacy from industry groups such as AABB, and from many other industry and clinical leaders supporting reimbursement for these innovative products.”
The new codes and payment rates, outlined in the table below, were published by CMS on October 30 in the Hospital Outpatient Prospective Payment System (HOPPS) Final Rule for CY2016 and will become effective January 1, 2016. The interim payment rates for CY2016 were based on payment rates for existing products determined by CMS to be the best proxy to pathogen-reduced blood components. Hospital claims data will be used to calculate payment rates for these new products in CY2018, per usual CMS rate-setting methods.

Click here to read the full press release.