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2014 ASP Drug Pricing Files

ASP Drug Pricing Files October 2014 Update

The files below contain the payment amounts that will be used to pay for Part B covered drugs for the fourth quarter of 2014.

Comparing the fourth quarter 2014 payment amounts with previous quarters reveals that, for the most part, average drug prices in the market remain relatively stable.  This quarter, on average, prices for the top Part B drugs decreased by 0.4 percent. 

For most of the higher volume drugs (35 out of the top 50), the prices changed 2 percent or less. Overall, the prices for 20 of the top 50 drugs decreased, while 3 remained the same. 

CMS remains interested in ensuring continued beneficiary access to Part B covered drugs. We will continue to monitor trends in pricing, as reflected by the published ASP payment rates, as well as utilization within the Medicare community.

Where applicable, the payment amounts in the quarterly ASP files are 106 percent of the Average Sales Price (ASP) calculated from data submitted by drug manufacturers. The quarter to quarter price changes are generally the result of updated data from the manufacturers of these drugs.

The Medicare Part B payment limits for valid HCPCS codes that are not included in the quarterly ASP pricing files will be determined by the local Medicare contractor.

CMS guidance requires physicians and other providers to bill using the appropriate HCPCS or CPT code and to accurately report the units of service. Physicians and other providers should ensure that the units billed do not exceed the maximum number of units per day based on the code descriptor, reporting instructions associated with the code, and/or other CMS local or national policy.

The notes column of the ASP price file identifies HCPCS codes with payment limits that were calculated using the AMP-based price substitution policy described in the CY 2013 Physician Fee Schedule Rule and published in the Federal Register on November 16, 2012 (77 FR 69141-2).