Looks like at least one MAC (Noridian) has spoken out about CAR-T coverage...seems it is covered for the FDA labeled indications which isn't much of a surprise but what is interesting is that they seem to be calling for the infusion of CAR-T to be a procedure/service that requires a 2 midnight stay - so treatment is covered if provided inpatient.  Of course the issue is that inpatient Medicare reimbursement is terrible but the outpatient payment has been set at ASP+6% so at least the CAR-T drug/product cost would be covered in the outpatient but it won't be as things stand now in the inpatient setting, yet this MAC has spoken up about the care setting and most clinicians believe that at least for now, it seems the inpatient setting is the most appropriate.  So now we wait to see what happens with reimbursement.
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