Last Modified: 5/4/2022
Location: FL, PR, USVI
Business: Part A, Part B
CMS created the new HCPCS code C9507 for COVID-19 convalescent plasma for use in the outpatient setting. This code is effective for dates of service on or after December 28, 2021, when administered in an outpatient setting. CMS released this information in the MLN Connects newsletter for Thursday, February 10, 2022
On December 28, 2021, the Food and Drug Administration (FDA) revised the emergency use authorization
for COVID-19 convalescent plasma with high titers of anti-SARS-CoV-2 antibodies. It’s authorized for treatment of COVID-19 in patients with immunosuppressive disease or getting immunosuppressive treatment, in the outpatient or inpatient setting.
Code C9507 is available for use in the outpatient setting for dates of service on or after December 28, 2021.
We are providing the following guidance for billing C9507 to prevent impacts to your claims processing.
Submit claims with:
• HCPCS code: C9507
• Status Indicator: S
• Ambulatory payment classification (APC): 1509
• Long descriptor: Fresh frozen plasma, high titer COVID-19 convalescent, frozen within 8 hours of collection, each unit
• Short descriptor: COVID-19 convalescent plasma
• Appropriate diagnosis coded to highest level of specificity
• Appropriate type of bill:
• 12x, 13x, or 85x
• Appropriate revenue code:
• 0383, 0390 or 0392
• Payment rate: $750.50 per unit
Beneficiary cost sharing will apply to COVID-19 convalescent plasma product code.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.