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Question:
Does Medicare require hospitals to report codes for packaged drugs?
Answer:
Although hospitals are not required to report the HCPCS codes for packaged drugs, it is essential that they bill charges for packaged drugs by including them in the charge for the procedure or service for which the drug is used or as a separate drug charge. This is critical because the costs of the packaged drugs are used for calculating the hospital’s outlier and transitional corridor payments. They are also used in the annual update of outpatient APC payment rates for the procedures and services with which the drugs are furnished.
CPT® copyright 2023 American Medical Association (AMA). All rights reserved.
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.
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