October 2021 Quarterly ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

MLN Matters Number: MM12342
Related CR Release Date: July 14, 2021
Related CR Transmittal Number: R10870CP
Related Change Request (CR) Number: 12342
Effective Date: October 1, 2021
Implementation Date: October 4, 2021

CR 12342 tells you about the Average Sales Price (ASP) methodology, which CMS bases on quarterly data manufacturers submit to us. We give the MACs ASP and Not Otherwise Classified (NOC) drug pricing files for Medicare Part B drugs on a quarterly basis. We include payment allowance limits under the Outpatient Prospective Payment System (OPPS) into the Outpatient Code Editor (OCE) through separate instructions in the Medicare Claims Processing Manual, Chapter 4, Section 50. Please make sure your billing staff is aware of these updates.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)12342.


            Last Updated Wed, 21 Jul 2021 20:32:03 +0000