The National Uniform Billing Committee (NUBC) finalized a series of new codes on inpatient claims for cell and gene therapies, thanks in part to the leadership of ASBMT. These changes are expected to go live on April 1, 2019.
The changes may assist with improved provider reimbursement over time, which may decrease payment-related access barriers. Junga Shah and Valerie Rinkle, from Nimitt Consulting, advocated for this change on behalf of ASBMT.
In a letter submitted to Centers for Medicare and Medicaid Services (CMS) in November 2017, ASBMT outlined a detailed scope of the changes that would need to be made by NUBC on this issue. The Society was then invited by NUBC to participate in a working group that met throughout 2018 to develop the specific changes approved in August.
This new coding structure sets up a framework that allows for clear, consistent reporting of cell and gene therapies, which is not possible in the current billing structure. Since these changes could be used to support payment models that require more transparency on inpatient billing claims, ASBMT is hopeful it could be used to further its advocacy efforts.
To see a full list of the changes, click here.