How CMS grants new technology add-on payments and determines substantial similarity
As New Technology Add-On Payments are approved by CMS, startups lay claim to code. The question is, does this code apply to everyone who wants it?
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New Technology Add-On Payments (NTAP) are a class of reimbursement that are meant to help pay for new technology that is not included in the diagnosis-related group (DRG) bundled payment.
Specifically, NTAP recognizes that current DRG payment rates can be a barrier to adopting new technology and represents an additional payment for hospital stays that use new technology determined by CMS to provide substantial clinical improvement and where the current DRG payment would be inadequate. NTAP applications are evaluated as part of the annual Inpatient Prospective Payment System (IPPS) rulemaking process. If an NTAP is approved, it remains in effect for three years following approval, at the end of which it is assumed that the costs of the new tec