Quarterly ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files - October 2019

MLN Matters Number: MM11343
Related CR Release Date: July 5, 2019
Related CR Transmittal Number: R4331CP
Related Change Request (CR) Number: 11343
Effective Date: October 1, 2019
Implementation Date: October 7, 2019

CR11343 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 September 13, 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/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c04.pdf. Make sure that your billing staffs are aware of these changes

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11343.

Last Updated Jul 11, 2019