COVID-19 Treatments Add-On Payment (NCTAP)
CMS issued an Interim Final Rule with Comment Period, which established the New COVID-19 Treatments Add-on Payment (NCTAP) under the Medicare Inpatient Prospective Payment System (IPPS), effective from November 2, 2020, until the end of the Public Health Emergency (PHE) for COVID-19. The Medicare program will provide an add-on payment for eligible inpatient cases that involve use of certain new products with current Food and Drug Administration approval or emergency use authorization to treat COVID-19.
The NCTAP is equal to the lesser of 65 percent of the operating outlier threshold for the claim; or 65 percent of the amount by which the costs of the case exceed the standard MS-DRG payment for eligible cases, including adjustment to the relative weight under Section 3710 the Coronavirus Aid, Relief, and Economic Security Act (CARES) Act.
NCTAP claims that are eligible for the 20 percent add-on payment are identified by the diagnosis code U07.1 (COVID-19) plus specific ICD-10-PCS codes for administration of remdesivir (Veklury), COVID-19 convalescent plasma, or baricitinib (Olumiant) in combination with remdesivir. All three of these therapies were issued Emergency Use Authorizations (EUAs) by the U.S. Food and Drug Administration (FDA) for COVID-19 treatment.
Hospitals should report the ICD-10-PCS code(s) for all products administered during the stay, regardless of whether or not the hospital received the product at no cost. However, hospitals should not report charges associated with the product received at no cost.
To review the specifics in their entirety, click here:
https://www.cms.gov/medicare/covid-19/covid-19-treatments-add-payment-nctap
