July 2022 Quarterly ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

Related CR Release Date: March 29, 2022
Related CR Transmittal Number: R11318CP
Related Change Request (CR) Number: 12685
Effective Date: July 1, 2022
Implementation Date: July 5, 2022

CR 12685 tell you that the Average Sales Price (ASP) methodology is based on quarterly data submitted to CMS by manufacturers. CMS will supply the contractors with the ASP and Not Otherwise Classified (NOC) drug pricing files for Medicare Part B drugs on a quarterly basis. Payment allowance limits under the OPPS are incorporated into the Outpatient Code Editor (OCE) through separate instructions that can be located in chapter 4, section 50 of the Internet Only Manual.

Make sure your billing staff knows about these changes.

View the complete CMS Change Request (CR)12685.

Last Updated Jun 15 , 2022