Healthcare professionals / Gastroenterology / EXALT^TM Model D Single-Use Duodenoscope / Pass-through Payment

Transitional Pass-through (TPT) Payment

U.S. Centers for Medicare & Medicaid Services (CMS) approved Boston Scientific’s application for TPT payment applicable to EXALT Model D effective July 1, 2020. This device-specific payment is in addition to the endoscopic retrograde cholangiopancreatography (ERCP) procedure payment. 

TPT Code: C1748

TPT has been used successfully by hospitals to receive reimbursement up to the full cost of EXALT Model D when treating Medicare patients in the hospital outpatient setting. Additionally, several hospitals across the country have confirmed that they are receiving payment from commercial payers for EXALT Model D. Please note that commercial payer coverage and payment is dependent on each individual hospital's contractual agreement with its payers. 

Inpatient ICD-10-PCS Procedure Codes

In response to our request, CMS created two unique ICD-10-PCS procedure codes for hospitals to facilitate reporting the use of single-use duodenoscopes, including EXALT Model D, in the hospital inpatient setting. Effective October 1, 2021.