CMS Publishes 4th Quarter ASP for Part B Covered Drugs

On September 14, 2009 CMS released files containing the payment amounts for Part B covered drugs for the fourth quarter of 2009. The payment amounts are 106% of the Average Sales Price (ASP) calculated from data submitted by drug manufacturers. The ASP is reviewed quarterly and a new table of payment allowance limits is published. Although the changes are small, practices need to be aware of them. The following drugs are watched closely by many ophthalmic practices. Rounded dollar amounts are per unit.

• Botox, 1 unit (J0585) – $5.51
  Triamcinolone, pres. Free, 1 mg (J3300) – $3.27
  Ranibizumab inj, 0.1 mg (J2778) – $406.76
  Bevacizumab, 0.25 mg (Q2024) (new code) – $1.44

The complete listing of reimbursement rates can be found at: http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/