MAC Implementation File 8 - FY 2025 New Technology Add-on Payment (NTAP) - Technologies Continuing to Receive NTAP in FY 2025			
Technology	Maximum Add-on Payment	ICD-10-CM/PCS Coding Used to Identify Cases Eligible for NTAP	Alternative Pathways Status
Thoraflex Hybrid Device	"$22,750.00"	X2RX0N7 in combination with X2VW0N7	Breakthrough Device
ViviStim Paired VNS System	"$23,400.00"	X0HQ3R8	Breakthrough Device
GORE TAG Thoracic Branch Endoprosthesis	"$27,807.00"	02VW3DZ in combination with 02VX3EZ	Breakthrough Device
Cerament G	"$4,918.55"	XW0V0P7	Breakthrough Device
iFuse Bedrock Granite Implant System	"$9,828.00"	"XNH6058, XNH6358, XNH7058, XNH7358, XRGE058, XRGE358, XRGF058, or XRGF358"	Breakthrough Device
Aveir AR Leadless Pacemaker	"$10,725.00"	X2H63V9	Breakthrough Device
Aveir Leadless Pacemaker (Dual-Chamber)	"$15,600.00"	X2H63V9 in combination with X2HK3V9	Breakthrough Device
Ceribell Status Epilepticus Monitor	$913.90	XX20X89	Breakthrough Device
CYTALUX (pafolacianine) (lung indication)	"$2,762.50"	"8E0W0EN, 8E0W3EN, 8E0W4EN, 8E0W7EN, or 8E0W8EN"	
CYTALUX (pafolacianine) (ovarian indication)	"$2,762.50"	"8E0U0EN, 8E0U3EN, 8E0U4EN, 8E0U7EN, or 8E0U8EN"	
DefenCath (taurolidine/heparin)	"$3,656.10"	XY0YX28	QIDP
DETOUR System	"$16,250.00"	"X2KH3D9, X2KH3E9, X2KJ3D9, or X2KJ3E9 "	Breakthrough Device
EchoGo Heart Failure 1.0	"$1,023.75"	XXE2X19	Breakthrough Device
EPKINLY (epcoritamab-bysp) and COLUMVI (glofitamab-gxbm)*	"$6,504.07"	"XW013S9, XW033P9, or XW043P9"	
Lunsumio (mosunetuzumab)	"$17,492.10"	XW03358 or XW04358	
Phagenyx System	"$3,250.00"	XWHD7Q7	Breakthrough Device
"REBYOTA (fecal microbiota, live-jslm) and VOWST (fecal microbiota spores, live-brpk)*"	"$6,789.25"	XW0H7X8 or XW0DXN9	
REZZAYO (rezafungin for injection) 	"$4,387.50"	XW033R9 or XW043R9	QIDP
SAINT Neuromodulation System	"$12,675.00"	X0Z0X18	Breakthrough Device
SPEVIGO (spesolimab)	"$33,236.45"	XW03308	
TECVAYLI (teclistamab-cqyv)   	"$12,899.59"	XW01348	
TERLIVAZ (terlipressin)	"$16,672.50"	XW03367 or XW04367	
TOPS System	"$11,375.00"	XRHB018 in combination with M48.062 	Breakthrough Device
XACDURO (sulbactam/durlobactam)	"$13,680.00"	XW033K9 or XW043K9in combination withone of the following: Y95 and J15.61;ORJ95.851 and B96.83	QIDP
			
*These two technologies were determined to be substantially similar to each other and were therefore evaluated as one application for new technology add-on payments under the IPPS.			
