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Takeda Pharmaceutical Company Limited Reimbursement Rate Adjustments

July 24, 2019

Effective for dates of service on or after July 1, 2019, reimbursement rates for select Takeda Pharmaceuticals antihemophilic products are adjusted. Providers may refer to the “Maximum Antihemophilic Factor Reimbursement” document, which can be retrieved via the Medi-Cal provider portal under the Transactions tab of the Medi-Cal website, for corrected reimbursement rate information. To access the transaction, providers must have a signed Medi-Cal Point of Service Network/Internet Agreement form on file, a National Provider Identifier (NPI) and Provider Identification Number (PIN).

The following products have been affected by the reimbursement rate adjustments:

National Drug Code (NDC) Product
00944-2841-10 RECOMBINATE 220-400 BJII
00944-2842-10 RECOMBINATE 401-800 BJII
00944-2843-10 RECOMBINATE 801-1240 BJII
00944-2844-10 RECOMBINATE 1241-1800 BJII
00944-2845-10 RECOMBINATE 1801-2400 BJII
00944-3026-02 RIXUBIS, 250 IU
00944-3030-02 RIXUBIS, 1000 IU
00944-3032-02 RIXUBIS, 2000 IU
00944-3034-02 RIXUBIS, 3000 IU
00944-3045-10 ADVATE 2000 IU BAXJECT III
00944-3046-10 ADVATE 3000 IU BAXJECT III
00944-3047-10 ADVATE 4000 IU BAXJECT III
00944-3051-02 ADVATE 250 IU BAXJECT III
00944-3052-02 ADVATE 500 IU BAXJECT III
00944-3053-02 ADVATE 1000 IU BAXJECT III
00944-3054-02 ADVATE 1500 IU BAXJECT III
00944-3940-02 HEMOFIL-M
00944-3942-02 HEMOFIL-M
00944-3946-02 HEMOFIL-M
00944-4622-01 ADYNOVATE 250 AQ BJIII
00944-4623-01 ADYNOVATE 500 AQ BJIII
00944-4624-01 ADYNOVATE 1000 AQ BJIII
00944-4625-01 ADYNOVATE 2000 AQ BJIII
00944-4626-01 ADYNOVATE 750 AQ BJIII
00944-4627-01 ADYNOVATE 1500 AQ BJIII
00944-4628-01 ADYNOVATE 3000 AQ BJIII
00944-7551-02 VONVENDI 650
64193-0424-02 FEIBA 1000 IU BJII
64193-0425-02 FEIBA 2500 IU BJII
64193-0426-02 FEIBA 500AQ KIT

A Retroactive Payment Adjustment will occur automatically for adjudicated claims containing these products with dates of service on or after July 1, 2019.