Fourth quarter ASP list stable; but for 2009, there are big gains, losses

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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 reviews CMS’s fourth-quarter 2009 Average Sales Price updates for Part B drugs and summarizes broader year-to-date price movement across frequently billed products. It is intended for medical billing and coding professionals who track drug payment changes, reimbursement trends, and CMS pricing updates affecting office-administered therapies and vaccines. The piece also outlines selected drugs with notable price increases and decreases and notes a rounding change in the quarterly pricing file.

Why This Topic Matters

ASP updates affect Medicare Part B drug payment amounts, so even modest pricing changes can influence reimbursement and practice billing operations. The article helps readers monitor which commonly billed drugs changed most during the quarter and over the course of 2009.

Article Sections

  1. Quarterly ASP update overview

    Summarizes the general direction of CMS pricing for the fourth quarter and compares overall movement across the drug list. It also notes factors affecting broad price shifts.

  2. Pricing methodology and file notes

    Explains details about the quarterly ASP file, including rounding observations and the effective date range for the pricing update. This section also frames the analysis period used in the article.

  3. Drugs with large 2009 price gains

    Highlights selected frequently billed drugs that showed notable increases during 2009. The section presents a short list of billing items with strong upward movement.

  4. Drugs with large 2009 price decreases

    Highlights selected frequently billed drugs that showed notable decreases during 2009. The section presents a short list of billing items with strong downward movement.

  5. Key ASP changes for Part B drugs for fourth quarter 2009

    Provides tabulated fourth-quarter payment changes for top-billed drugs, organized into decreases and increases. The section focuses on CMS pricing changes relevant to Part B drug billing.

What You Will Learn

  • How CMS quarterly ASP updates affect Part B drug payment trends
  • What broad pricing movement looked like in the fourth quarter of 2009
  • Which types of billed drugs experienced notable year-to-date price changes
  • How the article organizes major increase and decrease groups for commonly billed drugs
  • What effective date range applied to the fourth-quarter ASP update

Who Should Read This

  • Medical coders
  • Billing staff
  • Revenue cycle professionals
  • Physician practice managers
  • Infusion and injectable drug billers

Codes Discussed


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