CAP: Maybe this will take some sting out of drug costs for 2006, maybe not

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains the 2006 Medicare Competitive Acquisition Program as it relates to office-administered drugs in urology. It covers the program’s timing, vendor participation, administrative considerations, related Medicare payment context, and a table of common urology drug payment changes for the quarter-to-quarter transition. The piece is relevant to urologists, coders, and practice staff tracking drug reimbursement policy and billing workflow changes.

Why This Topic Matters

It helps readers understand a Medicare payment change that affects how drug costs, billing responsibilities, and practice operations are handled for common urology drugs.

Article Sections

  1. Overview of the Competitive Acquisition Program

    Introduces the Medicare program change and the reimbursement environment affecting urology practices in 2006.

  2. Implementation timing and vendor participation

    Covers the program’s revised start date, enrollment timing, and expected vendor participation.

  3. Billing, appeals, and administrative considerations

    Summarizes the administrative aspects of submitting claims, handling denials, and related practice responsibilities.

  4. Policy context for specific urology drugs

    Discusses how broader Medicare payment policy and related drug-payment concepts apply to selected urology medications.

  5. New prices for common urology codes

    Presents a quarter-to-quarter comparison table of common drug payment amounts used in urology practices.

What You Will Learn

  • How the Medicare Competitive Acquisition Program is positioned for office-administered drugs
  • What administrative issues practices are expected to manage under the program
  • How the article frames broader Medicare drug-payment policy changes affecting urology
  • What kinds of payment comparisons are shown for common urology drugs

Who Should Read This

  • Urologists
  • Medical coders
  • Billing staff
  • Practice administrators
  • Revenue cycle professionals

Codes Discussed


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