The Centers for Medicare & Medicaid Services (CMS) has released the April update to the Average Sales Price (ASP) Medicare Part B Drug Pricing files and revisions to prior quarterly pricing files. Medicare will use these pricing files to determine the payment limit for claims for separately payable Medicare Part B drugs processed or reprocessed on or after April 2, 2012 with dates of service April 1, 2012 through June 30, 2012.
For most of the higher volume drugs, prices are changed 2 percent or less this quarter, CMS said. The agency attributes this to a number of factors, including multiple manufacturers, alternative therapies, new products, generic entrants, and market shifts to lower-priced products.
The change methodology for the ASP files is based on quarterly data submitted to CMS by drug manufacturers. Payment allowance limits under the Outpatient Prospective Payment System (OPPS) are incorporated into the Outpatient Code Editor (OCE) through separate instructions.
February 10th, 2012