decisionhealth Newsletters, Part B News - 2015 Issue 4 (April)
Drug price changes show 101.9% higher payments for albuterol
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Article Overview
This article explains recent Medicare Part B drug price changes and compares which drugs saw payment increases or decreases under the ASP-based payment formula. It is aimed at providers, coders, and billing staff who track drug reimbursement trends, especially for office-administered drugs and HCPCS-coded medications. The article also discusses broad policy context affecting Medicare drug payment levels and notes examples of high-volume and low-volume drugs with notable price movement.
Why This Topic Matters
Medicare drug pricing changes can directly affect reimbursement, practice revenue, and budgeting for frequently billed drugs. Understanding these updates helps billing and coding teams monitor payment shifts and stay aware of policy proposals that may alter future reimbursement.
What You Will Learn
- How Medicare Part B drug pricing updates are analyzed across payable HCPCS drug codes
- Which broad categories of drugs experienced notable payment increases or decreases
- How policy proposals may affect overall Medicare drug payment levels
- Why volume and frequency of billing matter when evaluating pricing changes
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Physician practices
- Infusion and office-administered drug billers
Codes Discussed
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