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What is the purpose of the HOPPS add-on payment adjustment for non-highly enriched uranium (non-HEU) sources, and when did this policy first take effect? What is the status for 2024?
In 2024, CMS will continue the policy that took effect first on January 1, 2013, establishing a Q code with a $10 dollar add-on payment as an adjustment policy for radioisotopes derived from non-highly enriched uranium (non- HEU) sources; $2 of this payment is paid by the patient as a co-insurance. In the CY 2024 final rule CMS finalized that the additional $10 payment will end after December 31, 2025, as, beginning with CY 2026, the Medicare claims data used to set payment rates would reflect the full cost of non-HWU-sourced Tc-99m.
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