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Question:
What is the 2019 average sales price (ASP) rate for nonpass-through drugs and biologicals?
Answer:
For 2019, payment for nonpass-through drugs and biologicals that were not acquired through the 340B Program is made at a single rate of ASP + 6 percent (or ASP – 22.5 percent if acquired under the 340B Program), which provides payment for both the acquisition cost and pharmacy overhead costs associated with the drug or biological.
This information can be found at https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2019Downloads/R4255CP.pdf
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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