Attachment 3 - Item List.pdf

This document is a 2026 blood bank service fee schedule effective January 1 through December 31, 2026. The schedule lists billing codes and associated tests for blood bank services, organized into three primary categories: blood bank testing services, blood products, and blood product attributes.

Blood bank testing services include 36 billable tests ranging from basic procedures such as titration, antibody identification, and ABO/Rh(D) typing to specialized services including molecular red cell genotyping, platelet crossmatching, and rare unit handling. Testing fees also encompass ancillary services such as import fees, export coordination fees, after-hours fees, and physician consultation and evaluation services. Blood products listed include red blood cells (including leukoreduced and low-titer variants), platelets in various formulations, fresh frozen plasma, and cryoprecipitate antihemophilic factor available in standard and pooled configurations. Blood product attributes include specialized processing and matching services such as autologous fees, directed donation fees, CMV negative units, irradiation, HLA antigen-specific matching, and pediatric aliquot sets. The document notes that the schedule is subject to change. Specific fee amounts for all services are redacted in the provided version. The schedule applies to multiple effective date periods shown on page 2, with dates ranging from October through January across fiscal periods.