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Friday, January 30, 2026 6:55:52 PM
Companies generally receive the Transitional Drug Add-on Payment Adjustment (TDAPA) designation and see it take effect on January 1 (as part of the annual ESRD PPS update) or, less frequently, July 1 (as part of a quarterly release), depending on when the application is submitted.
January 1 (Annual Update): Many major approvals, such as for new oral-only phosphate binders, are aligned with the start of the calendar year.
July 1 (Quarterly Release): Recent approvals, such as DEFENCATH® (taurolidine and heparin), have taken effect on July 1.
Other Potential Dates: While January 1 and July 1 are key dates, TDAPA can technically begin at the start of any quarter (Jan, April, July, Oct) depending on the approval timeline.
Key Takeaways on Timing:
Application Timing: To get an early January effective date, applications are typically required in early July.
Average Timeline: CMS aims for an effective date one quarter after the HCPCS code is assigned, which is usually around 6 months after the quarterly application submission deadline.
Duration: Once approved, the TDAPA is generally paid for a 2-year period.
Particularly confusing for me is what I highlighted in bold. So the words early July to me do not mean July 1st. Is it like the 4th of July?
And then, it says that CMS aims for an effective date one quarter after the HCPCS code is assigned which is 6 months after the application. To me that adds up to 9 months???
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