This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV).

Effective Date: January 1, 2021
Summary of Article Changes: Updated prices for Prialt (Ziconotide) and Ropivacaine per quarterly ASP Drug File Update:

• Effective for 1/1/2021 - 3/31/2021
  • Prialt (Ziconotide) = $8.480
  • Ropivacaine = $0.066
• Effective for 4/1/2021 - 6/30/2021
  • Prialt (Ziconotide) = $8.395
  • Ropivacaine = $0.083
• Effective for 7/1/2021 - 9/30/2021
  • Prialt (Ziconotide) = $8.658
  • Ropivacaine = $0.076

Visit the Noridian website to view the full LCA or through the CMS MCD.