US · guidance
CMS Pub. 100-04, ch. 8, § 60.4.6.5
Payment for Darbepoetin Alfa (Aranesp) in the Hospital
Outpatient Department
(Rev. 2582, Issued: 11-02-12, Effective: 04-01-13, Implementation: 04-01-13)
When ESRD patients come to the hospital for an unscheduled or emergency dialysis
treatment they may also require the administration of Aranesp. For patients with ESRD
who are on a regular course of dialysis, Aranesp administered in a hospital outpatient
department is paid the MMA Drug Pricing File rate. Effective January 1, 2005, Aranesp
will be paid based on the ASP Pricing File.
Hospitals use bill type 13X (or 85X for Critical Access Hospitals) and report charges
under revenue code 0636. The total number of units as a multiple of 1mcg is placed in the
unit field. Value code 49 must be reported with the hematocrit value for the hospital
outpatient visits prior to January 1, 2006, and for all claims with dates of service on or
after January 1, 2008.
History
(Rev. 2582, Issued: 11-02-12, Effective: 04-01-13, Implementation: 04-01-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
42eabd5c32e63c68553b9997639e7ff09bb936bb7a9ee1b93c3ebc982f56940d
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