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.