Johnson & Johnson Health Care Systems Inc. submitted an application to the Centers for Medicare and Medicaid Services (CMS) for a New Technology Add-On Payment (NTAP) for TALVEY® for Federal Fiscal Year (FFY) 2025. On August 1, 2024, CMS approved 5 NTAP applications for technologies, including the application for TALVEY®, in the Inpatient Prospective Payment System final rule.
Effective October 1, 2024, TALVEY® is eligible for a New Technology Add-On Payment (NTAP).
The following table summarizes important points about the NTAP involving the use of TALVEY®:
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Summary of New Technology Add-On Payment for TALVEY® |
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Applicable Sites of Care |
Administration in an inpatient setting at acute care hospitals that are reimbursed under the Inpatient Prospective Payment System (IPPS) |
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Excluded Facilities |
Hospitals not reimbursed under the IPPS (eg, psychiatric hospitals, exempt cancer hospitals, hospital outpatient departments, physician offices, and others)2 |
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Qualifying Cases |
Discharges involving the use of TALVEY® post October 1, 2024, for which the cost of a case exceeds the prevailing Medicare Severity-Diagnosis Related Group (MS-DRG) payment1,3 |
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Maximum Additional Payment |
CMS limits new technology add-on payments to the lesser of 65 percent of the new medical service or technology, or 65 percent of the amount by which the costs of the case exceed the standard MS-DRG payment.4 As a result, the maximum NTAP for a case involving the use of TALVEY® is $12,899.59 for FFY 20251 |
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ICD-10-PCS Procedure Codes |
To identify inpatient cases involving the use of TALVEY®, report XW01329 - Introduction of Talquetamab antineoplastic into subcutaneous tissue, percutaneous approach, New Technology Group 95 |
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Effective Dates |
October 1, 2024, through September 30, 2025 |
For more details related to the NTAP now available for TALVEY®, please click here.