US · guidance
CMS Pub. 100-04, ch. 17, § 80.4.1
Clotting Factor Furnishing Fee
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.
Beginning January 1, 2005, a clotting factor furnishing fee is separately payable to
entities that furnish clotting factor unless the costs associated with furnishing the clotting
factor is paid through another payment system.
The clotting factor furnishing fee is updated each calendar year based on the percentage
increase in the consumer price index (CPI) for medical care for the 12-month period
ending with June of the previous year. The clotting factor furnishing fees applicable for
dates of service in each calendar year (CY) are listed below:
CY 2005 - $0.140 per unit
CY 2006 - $0.146 per unit
CY 2007 - $0.152 per unit
CY 2008 - $0.158 per unit
CY 2009 - $0.164 per unit
CY 2010 - $0.170 per unit
CY 2011 - $0.176 per unit
CY 2012 - $0.181 per unit
CY 2013 - $0.188 per unit
CY 2014 - $0.192 per unit
CY 2015 - $0.197 per unit
CY 2016 - $0.202 per unit
CY 2017 - $0.209 per unit
CY 2018 - $0.215 per unit
CY 2019 - $0.220 per unit
CY 2020 - $0.226 per unit
CY 2021 - $0.238 per unit
CY 2022 - $0.239 per unit
CY 2023 - $0.250 per unit
CY 2024 - $0.250 per unit
CY 2025 - $0.258 per unit
CY 2026 - $0.265 per unit
Annual updates to the clotting factor furnishing fee are subsequently communicated by a
Recurring Update Notification.
CMS includes this clotting factor furnishing fee in the nationally published payment limit
for clotting factor billing codes. When the clotting factor is not included on the Average
Sales Price (ASP) Medicare Part B Drug Pricing File or Not Otherwise Classified (NOC)
Pricing File, the contractor must make payment for the clotting factor as well as make
payment for the furnishing fee.
History
(Rev. 13379; Issued: 08-21-25; Effective: 01-01-26; Implementation: 01-05-26)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
42b1d89a406ad8e427f32826a8befd6c4e317880e57e7e9e72bbd971f5dcb3e0
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