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APC 09194

Tisagenlecleucel car-pos t

Historical IOCE Data

v27.2.0 (2026-07-01 to 2036-06-30) $614180.81

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$614180.81
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v27.1.1 (2026-04-01 to 2026-06-30) $566531.30

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$566531.30
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v27.0.2 (2026-01-01 to 2026-03-31) $591726.20

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$591726.20
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.3.3 (2025-10-01 to 2025-12-31) $578324.58

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$578324.58
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.2.4 (2025-07-01 to 2025-09-30) $578771.12

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$578771.12
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.1.5 (2025-04-01 to 2025-06-30) $565623.84

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$565623.84
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v26.0.6 (2025-01-01 to 2025-03-31) $529192.86

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$529192.86
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.3.7 (2024-10-01 to 2024-12-31) $523452.56

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$523452.56
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.2.8 (2024-07-01 to 2024-09-30) $518240.68

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$518240.68
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.1.9 (2024-04-01 to 2024-06-30) $511072.50

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$511072.50
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v25.0.10 (2024-01-01 to 2024-03-31) $484623.49

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$484623.49
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.3.11 (2023-10-01 to 2023-12-31) $466069.91

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$466069.91
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.2.12 (2023-07-01 to 2023-09-30) $468441.50

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$468441.50
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.1.13 (2023-04-01 to 2023-06-30) $476174.33

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$476174.33
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v24.0.14 (2023-01-01 to 2023-03-31) $453856.60

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$453856.60
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.3.15 (2022-10-01 to 2022-12-31) $444756.92

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$444756.92
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.2.16 (2022-07-01 to 2022-09-30) $430701.54

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$430701.54
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.1.17 (2022-04-01 to 2022-06-30) $429374.63

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$429374.63
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v23.0.18 (2022-01-01 to 2022-03-31) $434337.60

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$434337.60
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.3.19 (2021-10-01 to 2021-12-31) $425409.20

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$425409.20
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.2.20 (2021-07-01 to 2021-09-30) $421728.84

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$421728.84
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.1.21 (2021-04-01 to 2021-06-30) $425159.01

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$425159.01
Status Indicator? Status indicator assigned to the APC
K
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v22.0.22 (2021-01-01 to 2021-03-31) $429813.31

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$429813.31
Status Indicator? Status indicator assigned to the APC
G
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.3.23 (2020-10-01 to 2020-12-31) $427836.49

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$427836.49
Status Indicator? Status indicator assigned to the APC
G
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.2.24 (2020-07-01 to 2020-09-30) $435603.87

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$435603.87
Status Indicator? Status indicator assigned to the APC
G
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.1.25 (2020-04-01 to 2020-06-30) $426467.34

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$426467.34
Status Indicator? Status indicator assigned to the APC
G
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v21.0.26 (2020-01-01 to 2020-03-31) $441508.39

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$441508.39
Status Indicator? Status indicator assigned to the APC
G
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0
v20.3.27 (2019-10-01 to 2019-12-31) $440577.09

Description

"Tisagenlecleucel car-pos t"

Core Attributes

Payment Amount
$440577.09
Status Indicator? Status indicator assigned to the APC
G
Payment Indicator? Payment indicator assigned to the APC
2

Processing Flags

Mental Health ? APC subject to Mental Health/Partial Hospitalization Program (MH/PHP) logic. Values: 0 = not applicable 1 = applicable
No
Device Offset ? APC's device offset amount prior to v54. Refer to OFFSET_CODEPAIRS table for device offset amounts after v53.
0
Comp2 Id ? APC subject to observation composite APC processing prior to v62 (Note: EA&M composite levels I & II combined in v18.0). Values: 0 = not applicable 1 = possible level II observation composite APC 2 = possible level I observation composite APC
0
Nuc Rad Fb ? APC subject to nuclear medicine/radiopharm processing prior to v54. Values: 0 = not applicable 1 = applicable
0
Er Visit ? Emergency room visit and critical care APC subject to observation logic. Values: 0 = not applicable 1 = applicable
No
Comp1 Id ? APC subject to composite APC processing. Values: 0 = not applicable 1 = electrophysiology/ablation composite APC (v15.3) 2 = LDR prostate brachytherapy composite APC (v18.3)
0
Comp3 Id ? APC subject to multiple imaging composite APC processing. Values: 0 = not applicable 1 = Ultrasound Composite 2 = CT and CTA without Contrast Composite 3 = CT and CTA with Contrast Composite 4 = MRI and MRA without Contrast Composite 5 = MRI and MRA with Contrast Composite
0
Capc Srs ? APC subject to comprehensive APC processing for Stereotactic Radiosurgery (SRS). Values: 0 = not applicable 1 = applicable
0

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