The Medicare Modernization Act section 303(e)(1) added section 1842(o)(5)(C) of the Social Security Act which requires that, beginning January 1, 2005, a furnishing fee will be paid for items and services associated with clotting factor.

The Center for Medicare and Medicaid Services (CMS) includes the clotting factor furnishing fee in the published national payment limits for clotting factor billing codes. When the national payment limit for a clotting factor is not included on the Average Sales Price (ASP) Medicare Part B Drug Pricing File or the Not Otherwise Classified (NOC) Pricing File, the contractor must make payment for the clotting factor as well as make payment for the furnishing fee

The prices below reflect the Clotting Factor Furnishing Fee per IU effective January 1st of each year.

Calendar Year – Furnishing Fee per IU

CY 2005 - $0.140 per IU
CY 2006 - $0.146 per IU
CY 2007 - $0.152 per IU
CY 2008 - $0.158 per IU
CY 2009 - $0.164 per IU

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R1653CP [PDF 132KB] MM6277 [PDF 64KB]
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Page Last Modified: 01/02/2009 1:18:54 PM
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