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TheraSphere® is eligible for Medicare reimbursement. The product is billed to Medicare under HCPCS code C2616 and is assigned to Ambulatory Payment Classification (APC) 2616 for payment.
In addition to Medicare, TheraSphere® is also covered and reimbursed by the majority of commercial health insurance plans. These plans include HMO, PPO, indemnity, self-insured employers, national companies, small local plans and government-sponsored programs such as state Medicaid programs, and Tri-Care for military personnel.
Through TheraSphere® Reimbursement Services, BTG provides patients and health care providers a full range of reimbursement services including billing and coding support, material to support pre-certification for those health plans that require it, and patient assistance. Contact us for specific questions regarding the coverage and reimbursement of TheraSphere®.
The Pinnacle Health Group
Toll Free: 866-369-9290
Toll Fax: 877-499-2986