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2025A Ambulatory Payment Classification: 9074
Title: Makena, 10 mg
| 2025A Relative Weight: | 0 |
| 2025A Payment Rate: | $ 13.82 |
| 2025A National Unadjusted Copay: | $ 0.00 |
| 2025A Minimum Unadjusted Copay: | $ 2.77 |
Addendum D1 Information
Status Indicator: K
Item / Code / Service:
(1) Non-Pass-Through Drugs and Biologicals
(2) Therapeutic Radiopharmaceuticals
(3) Brachytherapy Sources
(4) Blood and Blood Products
OPPS Payment Status:
(1) Paid under OPPS; Separate APC payment.
(2) Paid under OPPS; Separate APC payment.
(3) Paid under OPPS; Separate APC payment.
(4) Paid under OPPS; Separate APC payment.
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| 2021 Top 10 OPPS Facility Claims for APC 9074* |
| NPI | Organization | APC 9074 Submitted |
| 1235215427 |
GEISINGER MEDICAL CENTER-MOOSIC-PA
|
XX
|
| 1215939210 |
BRFHH MONROE LLC-MONROE-LA
|
XX
|
| 1740291491 |
THE MONROE CLINIC, INC.-MONROE-WI
|
XX
|
| 1811977796 |
ST. MARY'S HEALTHCARE-AMSTERDAM-NY
|
XX
|
| 1982780094 |
BELOIT HEALTH SYSTEM INC-BELOIT-WI
|
XX
|
| 1922043744 |
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY-MIDDLETON-WI
|
XX
|
| 1376574277 |
NORTHSIDE HOSPITAL, INC.-CUMMING-GA
|
XX
|
| 1578778726 |
YALE NEW HAVEN HOSPITAL-NEW HAVEN-CT
|
XX
|
| 1518998699 |
UNITED HEALTH SERVICES HOSPITALS, INC.-BINGHAMTON-NY
|
XX
|
| 1144211301 |
NORTH CAROLINA BAPTIST HOSPITAL-CHARLOTTE-NC
|
XX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
J1726 Makena, 10 mg
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Sources: Updates of Addendum A and B are posted quarterly to the OPPS website. These addenda are a "snapshot" of HCPCS codes and their status indicators,
APC groups, and OPPS payment rates, that are in effect at the beginning of each quarter. The quarterly updates of Addendum A and Addendum B reflect
the OPPS Pricer changes that are part of the quarterly OPPS recurring update notification transmittals.
http://www.cms.gov/HospitalOutpatientPPS/AU/list.asp#TopOfPage
For more information on the Composite APC payment,
please see CMS Transmittal R2141CP.
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