CMS CR 14580: Clotting factor furnishing fee rises to $0.270 per unit for CY 2027

CMS issued Change Request 14580 on August 27, 2026, as Transmittal 13937 (Pub 100-04 Medicare Claims Processing Manual). The subject is the annual clotting factor furnishing fee update for 2027. The CR revises chapter 17, section 80.4.1.

EFFECTIVE DATE: January 1, 2027 (date of service unless otherwise specified). IMPLEMENTATION DATE: January 4, 2027.

This is a Part B drugs and biologicals payment-limit notice, not a CMS-HCC map change and not the live MSP CARC processing CR 14553 story.

What CR 14580 changes

The CR is a recurring update notification. It announces the calendar year 2027 clotting factor furnishing fee and revises the fee table in Pub 100-04 §80.4.1.

Business requirement 14580.1 tells contractors to make separate payment for the clotting factor furnishing fee when separate payment for the clotting factor is allowed and the payment limit for the clotting factor is not included on the ASP or NOC files.

The $0.270 per unit CY 2027 fee

For 2027, the clotting factor furnishing fee of $0.270 per unit is included in the published payment limit for clotting factors. Contractors shall add that fee to the payment for a clotting factor when no payment limit for the clotting factor is published on either the Average Sales Price (ASP) Medicare Part B Drug Pricing File or the Not Otherwise Classified (NOC) Pricing File.

The manual text says CMS includes this clotting factor furnishing fee in the nationally published payment limit for clotting factor billing codes. When the clotting factor is not on the ASP or NOC file, the contractor must pay for the clotting factor and for the furnishing fee.

Do not invent a clotting-factor HCPCS list from memory. Confirm the billing code and the current ASP or NOC row in the encoder or your MAC drug-pricing files before you change a charge master.

Why the fee exists

The Medicare Modernization Act section 303(e)(1) added section 1842(o)(5)(C) of the Social Security Act. That section requires a furnishing fee for items and services associated with clotting factor, beginning January 1, 2005.

Beginning January 1, 2005, a clotting factor furnishing fee is separately payable to entities that furnish clotting factor unless the costs associated with furnishing the clotting factor are paid through another payment system.

The fee is updated each calendar year based on the percentage increase in the consumer price index (CPI) for medical care for the 12-month period ending with June of the previous year. Annual updates are communicated by a Recurring Update Notification. CR 14580 is that notice for CY 2027.

Who has to act on the desk

Impacted contractors listed in the CR are A/B MAC Part A and A/B MAC Part B. Provider education is queued through the Medicare Learning Network after the CR issues. MACs link to the MLN content and may add local education after the national newsletter.

On a provider desk this is a Part B drug-billing and hemophilia specialty update:

• Update any internal CY 2027 fee schedule or charge-master note that still shows $0.265.
• Confirm whether the clotting factor you bill already carries the furnishing fee inside the published national payment limit.
• When the code is missing from ASP and NOC, expect the contractor to pay the clotting factor and the $0.270 per unit furnishing fee separately under BR 14580.1.

Look up drug and procedure descriptors in the drugs tool or the code book when the claim also depends on which clotting-factor code you report.

What this is not

It is not a CMS-HCC, V28, or RADV documentation change. A clotting factor furnishing fee does not rewrite risk-adjustment diagnosis rules. If the question is risk scores, use ICD-10 to HCC for the model year you are coding.

It is not the live October 2026 MPFSDB CR 14588 quarterly physician fee schedule database update, and it is not the live payer-only codes CR 14574 Pub 100-04 §190 story.

It is not NCCI PTP v32.3. That October edit package stays on hold for this desk.

This page stays on the fee and payment-file rules CMS printed in CR 14580.