Summary of New Technology Add-On Payment for TALVEY^®

Applicable Sites of Care

Administration in an inpatient setting at acute care hospitals that are reimbursed under the Inpatient Prospective Payment System (IPPS)

Excluded Facilities

Hospitals not reimbursed under the IPPS (eg, psychiatric hospitals, exempt cancer hospitals, hospital outpatient departments, physician offices, and others)²

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) payment^1,3

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

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

Effective Dates

October 1, 2024, through September 30, 2025