US · guidance
CMS Pub. 100-04, ch. 32, § 66.2
Services Identified as having Significant Cost for Medicare Advantage
Services Identified as having Significant cost under section 422.109(a)(2) of title 42 of the Code of Federal
Regulations Providers may bill the A/B MAC for these NCD services provided to a MA beneficiary.
Services Identified as having Significant cost
Service/Benefit Revenue
Code
HCPCS ICD-10-
PCS
Procedure
Significant
Cost Start
Significant
Cost End
CAR-T 0891 Q2041,
Q2042
XW033C3
or
XW043C3
08/07/2019 12/31/2020
History
(Rev. 10229, Issued: 07-21-20 Effective: 10-01-20, Implementation: 10-05-20)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5cb1af05ce9aecfcb76027f733c1d28af0f035d77e31dcce6a64210b95affa33
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