Eagle Pharmaceuticals, Inc. announced that Centers for Medicare & Medicaid Services has established a unique, product-specific billing code and granted transitional pass-through payment status for Barhemsys (amisulpride) injection. The new Healthcare Common Procedure Coding System (?HCPCS?) Level II code (?J-code?) is J-0184 ?Injection, amisulpride, per 1 mg? and will be effective on January 1, 2024, replacing the C-code (C-9153), which will be discontinued.

Beginning October 1, 2023, Barhemsys became eligible for separate reimbursement outside of the surgical bundled payment in both the ambulatory surgery center (?ASC?) and hospital outpatient department (?HOPD?) care settings. In addition to clinical complications that may negatively affect patient outcomes, PONV can delay hospital discharge; result in re-admission after in-patient procedures; and lead to day-case patients being admitted to the hospital, all of which can increase healthcare costs.2 By reducing these risks, Barhemsys offers the potential for significant economic savings to hospitals and ambulatory centers. J-codes are reimbursement codes used by commercial insurance plans, Medicare, Medicare Advantage, and other government payers for physician-administered drugs like Barhemsys and are intended to simplify the claims submission and documentation process, facilitating access for patients.

Transitional pass-through payments provide additional payment for new devices, drugs, and biologicals that meet eligibility criteria for a period of at least two years but not more than three years. The granting of pass-through status helps streamline the reimbursement process and facilitates patient access to Barhemsys.