decisionhealth Newsletters, Part B News - 2005 Issue 5 (May)
First- and second-quarter prices revised for some ASP drugs
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Article Overview
This article explains a CMS update to Medicare’s average sales price reimbursement system affecting selected drugs and related products in the first and second quarter of the year. It is relevant to coders, billing staff, reimbursement professionals, and practices that bill Part B drugs because it covers revised pricing activity, the timing of the updates, and the option to resubmit previously paid claims under carrier-specific rules. The content is focused on price revisions and source documentation rather than detailed coding policy.
Why This Topic Matters
ASP price revisions can affect claim reimbursement and may require review of previously submitted claims. Understanding which quarterly updates were revised helps billing teams monitor payment changes and align claims with current Medicare pricing information.
What You Will Learn
- How CMS revised ASP pricing for selected products in different quarters
- Which categories of Medicare-billed drugs and biologics were affected
- Why claim resubmission may be relevant after a pricing update
- How the article frames the timing of first-quarter and second-quarter revisions
Who Should Read This
- Medical coders
- Billing staff
- Reimbursement specialists
- Practice managers
- Part B billing personnel
Codes Discussed
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