As we discuss the Inpatient Prospective Payment System (IPPS) Proposed Rule for the 2025 fiscal year (FY), I want to call attention to the FY 2024 updates.
There are almost five months remaining in the current fiscal year, and hospitals are looking for money. One place I would like to suggest is Medicare Administrative Contractor (MAC) Implementation File 8. This file lists New Technology Add-On Payments (NTAPs). The NTAP is additional money paid on top of the MS-DRG reimbursement.
There are three tabs that specify New NTAPs, Continued NTAPs from the previous year, and Discontinued NTAPs. Each spreadsheet lists the title of the technology, the maximum add-on payment, the ICD-10-CM and/or ICD-10-PCS codes, and Alternative Pathways Status. Please be aware that this file was updated for Jan. 1, 2024 discharges.
The January update includes DefenCath, which has a maximum payment of $17,111.25. The ICD-10-PCS code that triggers the payment is XY0YX28. This NTAP is an antimicrobial catheter lock solution to reduce catheter-related bloodstream infections.
As you are investigating this addition, I would suggest reviewing all the items on the new and continued tabs with pharmacy, chargemaster coordinator, or the person who manages devices at your facility. There are 20 new NTAPs and 11 continued NTAPs. The additional reimbursement for the current year varies:
In FY 2023, some of the NTAPs were paid an additional $289,532.75.
While looking at the FY 2024 list, you can also download the FY 2025 proposed list of NTAPs. By looking at the proposed list of pharmaceuticals and devices, you can begin to prepare for this October. The FY 2025 list is not finalized, but you can get a jump on your preparation.
Some billing systems can apply the ICD-10-PCS code on the claim. Perhaps your billing system could apply the code for you.
It is important for health information management (HIM) to be active in the revenue cycle processes. Perhaps no one else is aware of the NTAP codes.
It is common for the NTAPs to be overlooked, and that means that money is left on the table.
Programming note:
Listen to senior healthcare consultant Laurie Johnson’s live Coding Report today on Talk Ten Tuesday with Chuck Buck and Dr. Erica Remer, 10 Eastern.
Resources:
EDITOR’S NOTE Day 3 of the federal shutdown continues. This article by Rose Dunn is part of a special section today published by RACmonitor and
Let’s start with some updates. We have all been Program for Evaluating Payment Patterns Electronic Report (PEPPER)-free for quite a while now, but I can
Please log in to your account to comment on this article.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
