BC Advantage - 2024 Issue 7

Hospital Outpatient Prospective Payment System

There are several key changes and updates to the Hospital Outpatient Prospective Payment System, taking effect July 1, 2024.   Here is a summary of the main points covered:   COVID-19 Monoclonal Antibody Therapy: New HCPCS codes (Q0224 for PEMGARDA and M0224 for administration) have been assigned for pre-exposure prophylaxis of COVID-19 in healthcare settings. CPT Proprietary Laboratory Analyses (PLA) Coding Changes: 26 new PLA codes (CPT codes 0450U-0475U) go into effect July 1, 2024. OPPS Device Pass-Through: Two new device pass-through categories (HCPCS codes C1605 and C1606) are preliminarily approved, with further discussion planned for CY 2025 rules...

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