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Question:
Are hemophilia clotting factors included in the IPPS rates for hospital inpatients?
Answer:
If a beneficiary is in a covered part A stay in a prospective payment system (PPS) hospital, the clotting factors are paid in addition to the MS-DRG payment. For hospitals subject to OPPS, the clotting factors, when paid under Part B, are paid the ambulatory payment classification (APC) rate.
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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