Although it’s still early in 2026, Congress is running out of time. While the appropriations process for fiscal year (FY) 2027 (October 1, 2026 – September 30, 2027) is well underway, policymakers are still debating Department of Homeland Security (DHS) funding for the remainder of FY2026. This funding impasse between Democrats and Republicans—and within the Republican caucus—has consumed Congressional bandwidth and created significant disruptions to airline travel. President Trump’s executive orders to temporarily pay TSA workers gave Congress some more time to debate, but without a legislation solution, long airport security lines will return.
Medicare FY 2027 IPPS Proposed Rule Webinar
Join ASTCT’s payer advisors from Nimitt Consulting and ASTCT’s Director of Government Relations Molly Ford, for a webinar covering key provisions in the FY 2027 IPPS proposed rule. The discussion will highlight proposed payment updates pertaining to stem cell transplantation and CAR-T and other immunotherapies, including increases to MS-DRG rates, changes to the fixed- loss outlier threshold and new technology add-on payment applications.
Key Highlights from the FY 2027 IPPS Proposed Rule
- FY 2027 base payment for MS-DRG 018 (CAR-T and Other Immunotherapies) increased to:
- ~$335,904 for cases with full product cost (an increase of ~$21K over FY 2026)
- ~$57,104 for cases without full product cost (e.g. clinical trial /expanded access).
- FY 2027 base payments for stem cell transplant MS-DRGs stayed relatively flat
- MS-DRG 014 (Allogeneic SCT): ~$88,152
- MS-DRG 016 (Autologous SCT w/ CC/MCC): ~$44,810
- MS-DRG 017 (Autologous SCT w/o CC/MCC): ~$36,732
- The outlier fixed-loss threshold is proposed to increase to ~$51,704, up from $40,397 in FY 2026.
- No new MS-DRGs proposed for cell and gene therapies but lots of discussion from CMS about reconfiguring other MS-DRGs.
- CMS did not include any updates on its planned shift to a market-based MS-DRG methodology, scheduled for implementation in FY 2029.
2026 Payer RFI Forms
ASTCT’s 2026 Payer Request for Information (RFI) forms are now available on the ASTCT website. Developed by ASTCT’s Payer Relations Committee, these fillable to help streamline the submission process and support member engagement with payers. Please contact us with any questions about these changes. Additionally, if you have ideas on how to improve the RFI files, please consider joining the volunteer group that maintains the files.
2026 RFI Forms
Updated CAR-T Therapy Coding and Billing Guide
ASTCT’s updated CAR-T Therapy Coding and Billing Guide reflects the latest policy and reimbursement developments affecting providers. This resource supports hospitals in navigating coding and billing for inpatient and outpatient CAR-T therapy and related services, including FDA-approved products and therapies delivered through clinical trials or expanded access programs.
What's New
- Aligning references to HIPAA-administrative simplification provisions to reflect current regulatory terminology
- Validating manufacturer Q-code descriptions against their published coding and billing guides
- Providing additional clarification regarding Medicare clinical trial and no-cost product billing
- Updating references to the final 2026 rules, where applicable
- Spelling out acronyms and adding definitions where appropriate to provide clarity
ASTCT’s CAR-T Therapy Coding and Billing Guide is updated regularly to ensure it remains a relevant and current resource for CAR-T providers.
View the Updated Guide.