Pharmacy Question for the Week of November 18, 2019

Pharmacy Compliance Question of the Week


What is the ASP payment rate established in the 2020 HOPPS Final rule for radiopharmaceuticals?


A payment rate continuation for drugs and radiopharmaceuticals will remain at ASP + 6%, which was established in the CY 2010 OPPS/ASC Final Rule. Additionally, CMS finalized an increased threshold payment for therapeutic radiopharmaceuticals of $130, noting that CMS intends to package radiopharmaceuticals priced at equal to or less than $125 into the Ambulatory Payment Classifications (APC) payments while offering separate payment for items that meet or exceed the threshold amount.