ADMA Biologics Receives Unique Temporary C-Code and Pass-Through Payment Status for ASCENIV
January 04, 2021 at 08:00 am
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ADMA Biologics, Inc. announced that the Centers for Medicare and Medicaid Services (CMS) has approved transitional pass-through payment status and established a new reimbursement C-code, C9072, for ASCENIV which is effective January 1, 2021. A C-code is a unique temporary product code established by CMS to help support Fee-for-Service pass-through payments in the Hospital Outpatient Prospective Payment System (OPPS). The formal implementation of the C-code will enable hospital outpatient departments to infuse ASCENIV in the outpatient setting and be reimbursed at the list price, also known as the Average Sales Price (ASP), for ASCENIV at +6%. Other payers, such as commercial insurers, may also use the C-code for billing purposes while awaiting a permanent J-Code, which ADMA expects will be assigned during 2021. Permanent J-codes can be used across all settings of care for government insurers and commercial payers to support timely claims submissions and receive standardized reimbursement rates.
ADMA Biologics, Inc. is an end-to-end commercial biopharmaceutical company dedicated to manufacturing, marketing and developing specialty biologics for the treatment of immunodeficient patients at risk for infection and others at risk for certain infectious diseases. The Company manufactures and markets three United States Food and Drug Administration (FDA)-approved plasma-derived biologics for the treatment of immune deficiencies and the prevention of certain infectious diseases: BIVIGAM (immune globulin intravenous, human) for the treatment of primary humoral immunodeficiency (PI); ASCENIV (immune globulin intravenous, human - slra 10% liquid) for the treatment of PI, and NABI-HB (hepatitis B immune globulin, human) to provide enhanced immunity against the hepatitis B virus. Through its ADMA BioCenters subsidiary, the Company also operates as an FDA-approved source plasma collector in the United States, which provides its blood plasma for the manufacture of its products.
ADMA BIOLOGICS, INC. 
