Centers for Medicare & Medicaid Services (CMS). Boston, MA: Alexion Pharmaceuticals, Inc. ANDEXXA ® (coagulation factor Xa (recombinant), inactivated-zhzo). Effective July 1, 2020, the CMS has granted ANDEXXA its permanent J-code, facilitating reimbursement in all hospital outpatient departments and freestanding emergency facilities in the United States 7ġ.Standardized code for ANDEXXA insurance claims across Medicare, Medicare Advantage, Medicaid, and commercial plans Hospitals not reimbursed under the Inpatient Prospective Payment Systems are not eligible to receive add-on payments. 6‡Įligibility to receive add-on-payments may vary. Many plans follow Medicare reimbursement guidance. 3,5 Commercial reimbursementĬommercial health plan reimbursement may vary. †NTAP reimbursement for this product has been renewed until September 30, 2022. Centers for Medicare & Medicaid Services (CMS) increased NTAPs in fiscal year 2020 to promote patient access and reimbursement confidence for “new” and “transformative technologies.” An NTAP provides additional payment to hospitals above the standard MS-DRG payment amount. Medicare coverage is available for ANDEXXA.

Medicare new technology add-on payment (NTAP)

Andexanet cost