2025 Part A MAC Update

ADD– 

Major Category III. A. – Chemotherapy

• J8611 ORAL METHOTREXATE (JYLAMVO) 7/1/2024
• J8612 ORAL METHOTREXATE (XATMEP) 7/1/2024
• J9075 INJ, CYCLOPHOSPHAMIDE, NOS 4/1/2024
• J9248 INJ MELPHALAN (HEPZATO) 1 MG 4/1/2024
• J9249 INJ, MELPHALAN (APOTEX) 1 MG 4/1/2024
• J9376 INJ POZELIMAB-BBFG, 1 MG 4/1/2024
• J9329 INJ, TISLELIZUMAB-JSGR 10/1/2024

Major Category III. D. - Customized Prosthetic Devices

• L5783 ADD LOW EXT MEC LIMB VOL SYS 4/1/2024
• L5841 ADDITION ENDOSKLETL KNEE-SHI 4/1/2024
• L8720 EXT LOW EXT SENS PROSTHE MEC 10/1/2024
• L8721 RECEPTOR SOLE L8720 REPLACE 10/1/2024

Major Category III. E. - Certain blood clotting factors

• C9172 INJ, BEQVEZ, PER TX DOSE 10/1/2024
• J7165 INJ, HUMAN-LANS, PER I.U 4/1/2024

Major Category IV. A. -Mammography Screening 

• 77063 SCREENING DIGITAL BREAST TOMOSYNTHESIS, BILATERAL 01/01/2015

Major Category IV. B. -Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)

• 90671 PNEUMOCOCCAL CONJUGATE VACCINE, 15 VALENT 07/01/2021
• 90739 HEPATITIS B VACCINE (HEPB), CPG-ADJUVANTED 01/01/2013
• 90759 HEPATITIS B VACCINE (HEPB), 3-ANTIGEN 01/01/2022

Major Category IV. D. -Screening Pap Smear and Pelvic Exams

• G0124 SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL 
• P3001 SCREENING PAP SMEAR BY PHYS. 

Major Category IV. E. -Colorectal Screening Services 

• G0327 COLORECTAL CANCER SCREENING; BLOOD-BASED BIOMARKER 07/01/2021
• 81528 ONCOLOGY (COLORECTAL) SCREENING 01/01/2016

Major Category IV. H. -Diabetic Screening 

• 83036 HEMOGLOBIN A1C 01/01/2006

Major Category V. A. - Therapies – INCLUSION

• G0541 NO PT PRSNT TRAIN INITIAL 30 1/1/2025
• G0542 CARE TRAIN PATIENTS, 15 MIN 1/1/2025
• G0543 GROUP TRAIN W/O PATIENT 1/1/2025

TERMINATE-

Major Category III. A. - Chemotherapy

• J9070 CYCLOPHOSPHAMIDE 100 MG INJ 4/1/2024
• J9371 INJ, VINCRISTINE SUL LIP 1MG 7/1/2024

Major Category IV. B. - Vaccines (Pneumococcal, Flu, Hepatitis B, or Covid-19)

• 0002A ADM SARSCOV2 30MCG/0.3ML 2ND 10/31/23
• 0003A ADM SARSCOV2 30MCG/0.3ML 3RD 10/31/23
• 0004A ADM SARSCOV2 30MCG/0.3ML BST 10/31/23
• 0011A ADM SARSCOV2 100MCG/0.5ML1ST 10/31/23
• 0012A ADM SARSCOV2 100MCG/0.5ML2ND 10/31/23
• 0013A ADM SARSCOV2 100MCG/0.5ML3RD 10/31/23
• 0021A ADM SARSCOV2 5X10^10VP/.5ML 1 01/01/21
• 0022A ADM SARSCOV2 5X10^10VP/.5ML 2 01/01/21
• 0031A ADM SARSCOV2 VAC AD26 .5ML 10/31/23
• 0041A ADM SARSCOV2 5MCG/0.5ML 1ST 10/31/23
• 0042A ADM SARSCOV2 5MCG/0.5ML 2ND 10/31/23
• 0051A ADM SARSCV2 30MCG TRS-SUCR 1 10/31/23
• 0052A ADM SARSCV2 30MCG TRS-SUCR 2 10/31/23
• 0053A ADM SARSCV2 30MCG TRS-SUCR 3 10/31/23
• 0054A DM SARSCV2 30MCG TRS-SUCR B 10/31/23 
• 0064A ADM SARSCOV2 50MCG/0.25MLBST 10/31/23
• 0091A ADM SARSCOV2 50 MCG/.5 ML1ST 10/31/23
• 0092A ADM SARSCOV2 50 MCG/.5 ML2ND 10/31/23
• 0093A ADM SARSCOV2 50 MCG/.5 ML3RD 10/31/23
• 0111A ADM SARSCOV2 25MCG/0.25ML1ST 10/31/23
• 0112A ADM SARSCOV2 25MCG/0.25ML2ND 10/31/23
• 0113A ADM SARSCOV2 25MCG/0.25ML3RD 10/31/23
• 0134A ADM SARSCV2 BVL 50MCG/.5ML B 10/31/23

Major Category IV. C. - Vaccine Administration

• G9141 INFLUENZA A H1N1,ADMIN W COU 12/31/11
• 90465 IMMUNE ADMIN 1 INJ, < 8 YRS 12/31/10
• 90466 IMMUNE ADMIN ADDL INJ, < 8 Y 12/31/10
• 90467 IMMUNE ADMIN O OR N, < 8 YRS 12/31/10
• 90468 IMMUNE ADMIN O/N, ADDL < 8 Y 12/31/10