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This information is provided for educational purposes only. Bristol Myers Squibb cannot guarantee insurance coverage or reimbursement. Coverage and reimbursement may vary significantly by payer, plan, patient, and setting of care and may be subject to frequent change. It is the sole responsibility of the healthcare provider to select the proper codes and ensure the accuracy of all statements used in seeking coverage and reimbursement for an individual patient.
Coding and billing for CAR T cell therapies will vary based on the patient’s condition, provided services, payer-specific requirements, and selected site/setting of care. It is critical for treatment centers to confirm specific payer requirements prior to claim submission in order to avoid processing delays or denials.
| HCPCS Level II Codes |
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| Hospital Revenue Codes |
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| ICD-10-PCS Codes |
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| CPT® Codes* |
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| Medicare Fee-for-Service (FFS) |
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| Medicare Advantage (MA) Plans | Starting in January 2021 (CAR T cell therapy is paid by MA plans):
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| Commercial Plans and Other Payers |
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*CPT codes, descriptions, and other data only are copyright 2021 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply.
Visit the Resource Library for informative downloadable tools.
CMS=Centers for Medicare and Medicaid Services; CPT=Current Procedural Terminology; FARS/HHSARS=financial assistance reporting system/health and human services acquisition regulations; HCPCS=Healthcare Common Procedure Coding System; ICD-10-PCS=International Classification of Diseases, Tenth Revision, Procedure Coding System.
For product-specific resources, click here.
CAR=chimeric antigen receptor.
This information is provided for educational purposes only. Bristol Myers Squibb cannot guarantee insurance coverage or reimbursement. Coverage and reimbursement may vary significantly by payer, plan, patient, and setting of care and may be subject to frequent change. It is the sole responsibility of the healthcare provider to select the proper codes and ensure the accuracy of all statements used in seeking coverage and reimbursement for an individual patient.
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