Formulary Guidance
Formulary Guidance
This page provides important information on prescription drug coverage policies under Medicare, the framework for CMS' review of Medicare prescription drug plan formularies, and instructions concerning formulary file uploads.
Click the selection that best matches your informational needs. Please check back as we will continue to update these resources regularly.
Please note that Transition related documents have been move to the "Part D Transition" page - click the link in "Links within CMS" to access the page.
Downloads
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2024 Pricing Data Guidelines and Calendar (v 07 07 23) (ZIP) -
2023 Pricing Data Guidelines and Calendar (V 06 30 22) (ZIP) -
2022 Pricing Data Guidelines and Calendar (V 06 30 21) (ZIP) -
2021 Pricing Data Guidelines and Calendar (V 06 08 20) (ZIP) -
2020 Pricing Data Guidelines and Calendar (v06 24 19) (ZIP) -
HPMS Memo: Medical Supplies Associated with the Injection of Insulin (v 01 05 2018) (PDF) -
Formulary Reference File FAQ (ZIP) -
Formulary Reference File Archive (ZIP) -
Excluded Drug Reference File FAQ (ZIP) -
CY 2024 September Formulary Reference File (ZIP) -
CY 2023 OTC Reference File (ZIP) -
CY 2023 October Formulary Reference File (ZIP) -
CY 2023 Excluded Drug Reference File (ZIP) -
OTC Reference File FAQ (ZIP)
Page Last Modified:
11/21/2023 03:19 PM