NTAP Reimbursement

Effective October 1, 2019, Medicare will provide an add-on payment for the T2Bacteria Panel of up to $97.50 per qualifying case to Inpatient Prospective Payment System (IPPS)-participating acute care hospitals. This add-on payment will be incremental to the Medicare Severity-Diagnosis Related Group (MS-DRG) reimbursement for qualifying Medicare inpatient cases based on the cost of the case. Hospitals report the use of the T2Bacteria Panel by recording an ICD-10 procedure code (ICD-10-PCS code) on the claim billed to Medicare. The codes accompany the other ICD-10-PCS codes billed for the inpatient services.

Summary of the NTAP details for T2Bacteria Panel:

Effective date for NTAP: October 1, 2019

Eligible facilities: IPPS-participating acute care hospitals

Setting of care: IPPS inpatient hospital

Eligible patients: Medicare-eligible patients

ICD-10-PCS code: XXE5XM5 (Measurement of Infection, Whole Blood Nucleic Acid-base MicrobialDetection, New Technology Group 5)

Amount of NTAP: Up to $97.50 per qualifying case

“The T2Bacteria Test Panel represents a substantial clinical improvement over existing technologies because it reduces the proportion of patients on inappropriate therapy, thus reducing the rate of subsequent diagnostic or therapeutic intervention as well as length of stay and mortality rates caused by sepsis causing bacterial infections.”²

Species identification in just hours: Data generated by T2Bacteria users demonstrate its ability to benefit patients in the emergency department by providing information that leads to more rapid time to delivery of effective therapy, de-escalation of unnecessary therapy, and helping avoid premature discharge and readmission to the emergency department.³

T2Bacteria identifies:

• 50% of all bacterial bloodstream infections¹
• 70% of all blood culture species in the emergency department³
• 90% of deadly ESKAPE pathogens⁴

To learn more about the New Technology Add-on Payment, please contact us.

Download NTAP brochure

*A combination of samples was run in both the prospective and contrived arms of the study. T2Bacteria showed an overall average sensitivity of 90% in the prospective arm of the study, with an overall average PPA of 97% in the contrived arm of the study.

1. Nguyen, M. H., et al. (2019) Performance of the T2Bacteria Panel for Diagnosing Bloodstream Infections. A Diagnostic Accuracy Study. Annals of Internal Medicine.
2. United States CMS FY 2020 inpatient prospective payments system final rule
3. Voigt, Christopher, et al. “The T2Bacteria assay Is a sensitive and rapid detector of bacteremia that can be initiated in the emergency department and has potential to favorably influence subsequent therapy.” The Journal of emergency medicine 58.5 (2020): 785-796.
4. Karlowsky, JA, et al. Annals of Clinical Microbiology and Antimicrobials, 2004