decisionhealth Newsletters, Coder Pink Sheets - 2005 Issue 4 (April)
You may not know it, but . . .
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Article Overview
This brief article discusses reported problems physicians have had obtaining certain Medicare Part B drugs at listed pricing and the resulting review of average sales price information by CMS-related staff. It is relevant to medical practices, coding and billing staff, and specialty groups that follow Part B drug reimbursement policy and drug pricing updates.
Why This Topic Matters
Accurate Medicare drug pricing affects practice reimbursement and access to buy-and-bill medications, so changes or corrections to pricing files can influence day-to-day billing and financial operations.
What You Will Learn
- The article’s focus on Medicare Part B drug pricing concerns
- How pricing review activity may affect physician practices
- Why specialty societies are monitoring the issue
- Which organizations and staff groups are involved in the pricing review process
Who Should Read This
- Physician practices
- Medical coders
- Biller/reimbursement staff
- Practice administrators
- Specialty society staff
Codes Discussed
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