Administrators To Learn About
Medicare Billing for Cell Processing

CPT Codes for cell processing are now being recognized for payment under Medicare and Medicaid. The implications will be presented in a session of the BMT Center Administrators Conference on Thursday afternoon, Feb. 14, during the BMT Tandem Meetings in San Diego.

Effective with the New Year, the Centers for Medicare and Medicaid Services (CMS) has assigned temporary payment values for cell processing services, pending acquisition of actual claims data submitted over the next two years.  

“This will finally bring a revenue stream for cell processing, as the burden of FDA regulation has added to costs,” said James Gajewski, MD, who will be addressing the administrators.  “It will be important that transplant programs charge the correct actual cost for these services because the billing information will be used by CMS to determine future reimbursements.”

The conference presentation will review the definition of services for individual CPT codes.  The goal, according to Dr. Gajewski, is that attendees leave with an understanding of the codes and their respective procedures and specific steps for appropriate billing for these services.  “For example, lab director time and certain quality assurance testing such as flow cytometry can be included in the value of the services, but other quality tests such as microbiology cultures cannot be included,” he said.  "The codes can be used only once per procedure in 24 hours."

Dr. Gajewski chairs the ASBMT Committee on CPT Codes.  Others participating in the presentation will be Theresa Wiegmann, JD, director of public policy and special counsel for the AABB, and John McMannis, PhD, laboratory director for cell processing at M.D. Anderson Cancer Center. 

The BMT Center Administrators Conference, like other parallel conferences for transplant nurses, transplant pharmacists and data managers, is open to all registrants at the BMT Tandem Meetings.