2021 ASP Drug Pricing

Medicare Part B Drug Average Sales Price & Payment Allowance Limits

CMS guidance requires physicians & 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 Medicare Part B payment limits for valid HCPCS codes that are not included in the quarterly ASP pricing will be determined by the local Medicare contractor.