Pharmacy Question for the Week of June 28, 2021

Pharmacy Compliance Question of the Week

Question:

Have the payment rates in the physician office setting for radiopharmaceuticals changed recently?

Answer:

The payment rates in the physician office setting for radiopharmaceuticals remain unchanged. CMS clarified that radiopharmaceuticals are not subject to average sales price (ASP) methodology for payment in this setting and that carriers should use the payment methodology in place as of November 2003.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.