ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files - January 2020

MLN Matters Number: MM11495
Related CR Release Date: September 27, 2019
Related CR Transmittal Number: R4404CP
Related Change Request (CR) Number: 11495
Effective Date: January 1, 2020
Implementation Date: January 6, 2020

CR11495 informs MACs about new and revised Average Sales Price (ASP) and ASP Not Otherwise Classified (NOC) drug pricing files for Medicare Part B drugs. The Centers for Medicare & Medicaid Services (CMS) will make files available for download on or after December 16, 2019. CMS gives MACs the ASP and NOC drug pricing files for Medicare Part B drugs on a quarterly basis. Payment allowance limits under the Outpatient Prospective Payment System (OPPS) are incorporated into the Outpatient Code Editor (OCE) through separate instructions available in Chapter 4, Section 50 of the Medicare Claims Processing Manual found at https://www.cms.gov/files/document/chapter-4-part-b-hospital-including-inpatient-hospital-part-b-and-opps-0. Make sure that your billing staffs are aware of these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11495.

 

            Last Updated Thu, 16 Dec 2021 18:23:40 +0000