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.