In 2011, CMS1 issued a National Coverage Determination (NCD) and Q-code for PROVENGE that simplify patient coverage criteria and expedite electronic billing and payment.
All Medicare Administrative Contractors cover PROVENGE, and reimburse for administration2, based on the FDA-approved label, per the NCD.
Download the latest guide for updated coding and billing instructions, with annotated forms to help minimize errors that can delay reimbursement: