Provider/Supplier Type(s) Impacted: Not applicable.

Reason Codes: Not applicable.

Claim Coding Impact: This will impact every code on the ASP file for Dates of Service submitted prior to June 30, 2026, for claims processing on or after July 1, 2026. Impacted claims may be overpaid or underpaid. Initial estimates are around 40,000 claims for JA and 40,000 claims for JD, however these volumes are rough estimates and a mass adjustment will be used to identify the actual volume of claims impacted.

Description of Issue: Noridian identified that a job required to prepare the July ASP (Drug, Pharmacy Supply, and Dispensing Fees) file load associated with CR 14422, July 2026 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files, was not requested to run prior to loading the file. This issue resulted from a misunderstanding of the required processing sequence. Because the job was not executed in sequential order, the existing fees were not shifted back one quarter to accommodate the July pricing updates. As a result, all incoming ASP codes with dates of service prior to July 1, 2026, were aligned to incorrect quarterly pricing. For example, claims with an April date of service were paid using January rates.

Noridian Action Required: Noridian is monitoring this issue and will ensure all affected claims are reprocessed through a mass adjustment.

Provider/Supplier Action Required: Not applicable.

Proposed Resolution/Solution: Not applicable.

Date Reported: 07/21/26

Date Resolved: