Question:

If a drug is not listed in the Medicare ASP or NOC file, does that mean it’s not covered?

Answer:

For drugs or biologicals not listed in the average sales price (ASP) or not otherwise classified (NOC) drug-pricing files, Medicare administrative contractors (MACs) determine the payment allowance limits in accordance with the policy described in Chapter 17, Section 20.1.3, of the Medicare Claims Processing Manual at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c17.pdf. The discussion about ASP or NOC files starts in the fourth paragraph.

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