Annual Clotting Factor Furnishing Fee Update

The annual update to the clotting factor furnishing fee is $0.170 per I.U. and is effective from Jan. 1, 2010 to Dec. 31, 2010. This fee is included in the published payment limit for HCPCS Level II clotting factor billing codes (J7189-J7195) and added to the payment for a clotting factor when no payment limit is published either on the Average Sales Price (ASP) Medicare Part B Drug Pricing File or the Not Otherwise Classified (NOC) Pricing File.

Note that HCPCS Level II code J7197 Antithrombin III (human), per i.u. does not describe a clotting factor and does not include the clotting factor furnishing fee in its payment, as of July 1.

The clotting factor furnishing fees applicable for service dates in each calendar year are listed below:

  • 2005 – $0.140 per I.U.
  • 2006 – $0.146 per I.U.
  • 2007 – $0.152 per I.U.
  • 2008 – $0.158 per I.U.
  • 2009 – $0.164 per I.U.
  • 2010 – $0.170 per I.U.

Source: The Centers for Medicare & Medicaid Services (CMS) transmittal 1829, change request 6673, issued Oct. 16.


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