What is new technology add-on payment?
The new medical service or technology add-on payment policy under the IPPS provides additional payments for cases with relatively high costs involving eligible new medical services or technologies. The payment mechanism is based on the cost to hospitals for the new medical service or technology.
What is NTAP payment?
Since 2001, the Centers for Medicare & Medicaid Services has offered manufacturers of new, groundbreaking technologies the ability to apply for a New Technology Add-on Payment (NTAP) designation for their drug, device or diagnostic that will provide hospitals with extra payments when they use the product for the 2-3 …
What are Medicare add-on payments?
We describe the new technology add-on payment (NTAP) program used by the Centers for Medicare and Medicaid Services (CMS) to provide additional payment for breakthrough technologies in the Medicare hospital inpatient prospective payment system (IPPS). We also evaluate spending under the program.
How is NTAP calculated?
The total payment amount for a IVL case that qualifies for an NTAP will consist of the full MS-DRG payment + 65% of the difference between the reported cost of the discharge and the MS-DRG payment, up to a maximum of $3,666 per case. The NTAP payment amount is then added to the hospital assigned DRG payment.
How long does an NTAP last?
Once a technology is granted new technology add-on payment status, a hospital is eligible to receive NTAPs for up to three years.
What is NTAP coding?
In 2020, CMS determined that a New Technology Add-on Payment (NTAP) could be applied to technology that assists with LVO triage and notification for stroke, such as Rapid LVO, as it was seen to significantly improve the care of Medicare beneficiaries. In August 2021, CMS extended the NTAP through fiscal year 2022.
What Is an NTAP code?
Introduced in 2001, the CMS NTAP program was created by Congress to help close this gap and support timely access to innovative therapies for the Medicare population. For technologies accepted under this program, CMS provides an additional payment to hospitals above the standard MS-DRG payment amount.
What criteria does CMS use to determine eligibility for NTAP?
For a technology to be eligible for NTAP, it must meet three criteria: (1) the technology must be considered new, as defined by the Centers for Medicare and Medicaid Services (CMS) as within two to three years following FDA approval; (2) the technology must be considered costly and inadequately reimbursed under the …
What percent of costs will CMS reimburse QIDP that have been approved for NTAP?
Add-on payments for QIDPs will also increase to 75 percent of the cost of the product or the additional cost of the case, whichever is lower. Other therapies granted NTAP are paid at 65 percent of the product’s cost.
Why does the indirect medical education adjustment add reimbursement for teaching facilities?
The indirect medical education (IME) and disproportionate share hospital (DSH) adjustments to Medicare’s prospective payment rates for inpatient services are generally intended to compensate hospitals for patient care costs related to teaching activities and care of low income populations.
What are NTAP NOTAMs?
Types of NOTAMs Include In the United States these NOTAMs are published in the Notices To Airmen Publication ( NTAP ) which is issued every 28 days. International NOTAMs : Any NOTAM intended for distribution to more than one country would be considered an international NOTAM .