Tag Archives: Drug Price

INSIDE THIS ISSUE CMS News New HCPCS® Codes Effective January 1, 2020 Coming Soon Drug Reimbursement Code Price Updates 68 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices New Clinical and Billing Information CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases […]

The following questions were submitted by attendees during the most recent Quarterly Drug Coding, Reimbursement, and Pipeline Update Webinar for Q3 2019. or      Q:  On the “Pricing Updates” slide it shows that the majority of Code Price changes were increases, but the Medicare Allowable ASP price changes showed a majority which were decreases. Why […]

INSIDE THIS ISSUE CMS News 2019-2020 Influenza Vaccine Season NDCs Now Available New HCPCS Code J0642-Injection, levoleucovorin (khapzory), 0.5 mg and Revised Code Description for J0641-levoleucovorin, 0.5mg Coming Soon New HCPCS Drug Q-Codes effective October 1, 2019 New HCPCS Drug J-Codes effective October 1, 2019 New HCPCS Drug Code Revisions and Discontinuations effective October 1, […]

INSIDE THIS ISSUE CMS News 2019-2020 Influenza Vaccine Season NDCs Now Available New HCPCS Drug Q-Codes effective October 1, 2019 New HCPCS Drug J-Codes effective October 1, 2019 New HCPCS Drug Code Revisions and Discontinuations effective October 1, 2019 Drug Reimbursement Code Price Updates 48 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices […]

Join RJ’s Product and Clinical teams as they walk through the multitude of different combinations of drug claims and pricing methodologies, via clips from the webinar “Shedding Light on Medically Covered Specialty Drug Pricing Methods.” In the following clip, Chris Webb explains the application and breakdown of the NDC or National Drug Code. All past […]

INSIDE THIS ISSUE CMS News 2019-2020 Influenza Vaccine Season NDCs Now Available Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of the 87 […]

INSIDE THIS ISSUE CMS News New, Revised, and Deleted HCPCS® Effective July 1, 2019 Quarterly ASP (Average Sales Price) Pricing File Released Hospital OPPS (Outpatient Prospective Payment System) Update Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Software Updates Data Enhancements Coming Soon CODE UPDATES Large Price Changes: We identify and report […]

Many payors have incorporated policies for providers to inform payors on discarded or wastage amounts of drugs in single-use packages. To ensure appropriate reimbursement, the providers are required to submit two claim lines for the administered drug.  One claim line reflects the dosage administered to the patient and the second is for the wastage amount. […]

INSIDE THIS ISSUE CMS News New, Revised, and Deleted HCPCS® Effective July 1, 2019 Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Software Updates Data Enhancements Coming Soon CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail […]

INSIDE THIS ISSUE CMS News New, Revised, and Deleted HCPCS® Effective July 1, 2019 Upcoming in the June Update Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Software Updates Data Enhancements Coming Soon CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or […]