Medicare FY 2025 IPPS Proposed Rule Webinar

Join ASTCT Director of Government Relations, Alycia Maloney, JD, and the reimbursement and policy advisors to ASTCT from Nimitt Consulting, for the Medicare FY 2025 IPPS Proposed Rule webinar on May 15 at 12 p.m. CDT.

Maloney and Nimitt will cover multiple CMS proposals for FY 2025, including the following key points:

• Proposed increases to the MS-DRG base payment rates for stem cell transplant and CAR-T/Other Immunotherapy inpatient Medicare cases, including the following:
  • Allogeneic HSCT (DRG 014) payment rate of $93,891, which is approximately $11,000 more than FY 2024
  • Autologous HSCT (DRGs 016 & 017) payment rate of $43,068, which is a slight decrease from the FY 2024 payment rate of $43,249
    • The recently approved gene therapies for sickle cell disease and transfusion-dependent beta-thalassemia are mapped to these MS-DRGs
  • MS-DRG 018 payment rate of $274,413 – an increase of approximately $16,000 from FY 2024
    • MS-DRG 018 reduced payment rate of approximately $93,000 for clinical trial
• Proposed Fixed Loss Outlier Threshold amount of $49,237 – an additional loss of approximately $7,000 per case from FY 2024
• Proposed changes to the New Technology Add-on Payment policies and processes
  • Proposal to pay up to 75% of the determined product cost for gene therapies used to treat sickle cell disease
  • Modification of the third-year anniversary date for a potential third year of NTAP eligibility from April 1 to October 1 (would be effective for FY 2026, not FY 2025) 

Comments can be submitted to CMS via https://www.regulations.gov and are due by June 10, 2024.

There will be a Q&A section at the end of the webinar, so be sure to register and submit any questions in advance that you would like answered during the webinar to info@astct.org. If you are unable to join, the recording will be made available. 

Please consider sharing this webinar with your network of physicians, administrators, providers, or any other colleagues that may be interested.