decisionhealth Newsletters, Part B News - 2019 Issue 7 (July)
New ASP drug price update shows unusual 14% overall jump
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Article Overview
This article explains a CMS average sales price update for Medicare Part B drugs and highlights how the quarterly payment limit list changed over time. It is useful for billing, coding, reimbursement, and pharmacy stakeholders who track drug pricing trends, ASP-based payment limits, and the mix of drug codes appearing in the file. The piece provides a broad market summary plus a table of selected drug items and their year-over-year payment limit changes.
Why This Topic Matters
ASP updates affect reimbursement and charge capture for drugs paid under Medicare Part B. Readers monitoring drug pricing trends, provider margins, and code-level updates may want to compare the changes summarized here with their own billing or contracting data.
Article Sections
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Benchmark of the week
A short market-focused overview of the latest CMS average sales price update and its significance for drug pricing trends.
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Drug pricing changes in the ASP update
A summary of overall movement in the pricing file, including the mix of items that increased, decreased, or were newly listed, along with selected drug items highlighted in the article.
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Code and payment limit table
A tabular listing of selected drug entries from the CMS ASP file with payment limit comparisons across years.
What You Will Learn
- How a CMS ASP update is used to review Medicare drug payment trends
- What kinds of broad pricing changes were highlighted in the latest quarterly file
- Which drug-related billing items were singled out as notable in the article
- How the article frames the relevance of ASP changes for reimbursement monitoring
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Pharmacy reimbursement analysts
- Provider compliance teams
- Healthcare finance teams
Codes Discussed
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