Question:

How much will CMS pay for 340B drugs in 2019?

Answer:

In 2018, the Centers for Medicare & Medicaid Services (CMS) finalized a policy to pay the average sales price (ASP) minus 22.5 percent under the Medicare Physician Fee Schedule (MPFS) for separately payable 340B-acquired drugs furnished in hospital departments paid under the outpatient OPPS. For 2019, CMS adopted the same policy for nonexcepted, off-campus provider-based departments (PBDs) of a hospital.

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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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