Pharmacy Question for the Week of January 9, 2017

Question:

For this year, how will DME infusion drugs be paid by Medicare?

Answer:

For claims with a date of service on or after January 1, 2017, most of the payment for infusion drugs furnished through a covered item of durable medical equipment (DME) will be based on the average sales price (ASP) of the drugs. Medicare Administrative Contractors (MACs) will determine payment for DME infusion drugs that do not appear on the ASP drug-pricing files.

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.

CPT is a registered trademark of the American Medical Association.

Pharmacy Question for the Week of January 9, 2017

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