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Minimum Number of Drug Pricing Files That Must Be Maintained Online for Medicare Provider Types Affected Provider Action Needed Background Since January 1, 2003, Medicare carriers, including DMERCs, have paid drug claims based on the prices shown on the Single Drug Pricer (SDP) files. The Centers for Medicare & Medicaid Services (CMS) is creating a new minimum standard for the number of online pricing files maintained by carriers and DMERCs for determining drug prices. The new minimum standard is raised from five to eight fee screens/pricing files for Part B drugs billed to carriers and DMERCs for payment on a fee-for-service basis. This will allow Medicare to be more precise in paying the rate in effect at the time services are provided. Additional Information From that Web page, look for CR 3231 in the CR NUM column on the right, and click on the file for that CR. If you have any questions, please contact your carrier/DMERC at their toll-free number, which may be found at: http://www.cms.hhs.gov/MedlearnProducts/downloads/CallCenterTollNumDirectory.pdf Disclaimer For additional information, visit the Medlearn Matters Web page at www.cms.hhs.gov/medlearn/matters. Related Change Request (CR) #:
3231 Related CR Release Date: August 3,
2004 Effective Date: January 1,
2005 Posted: 12/16/2004 [ ]
CPT codes, descriptions, and other data only are copyright 2003 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.
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