CMS Announces ASP Pricing Information

The Centers for Medicare & Medicaid Services (CMS) has announced the January 2005 Average Sales Price (ASP) pricing information for chemotherapy drugs and supportive care drugs that will be effective on January 1, 2005.

Please use the following link to the CMS website to obtain additional information and actual payment amounts: Medicare Part B Drugs Average Sales Price (ASP) Information Resource.

Also available on the ASH Web site is the ASP pricing file.

CMS also has issued its instructions to Medicare carriers concerning the new Cancer Care Demonstration project, including:

• Documentation for the demonstration project should include recording of patient responses regarding levels of nausea/vomiting, pain, and fatigue in the medical record, and reporting of the corresponding G codes on the CMS-1500 form. No additional documentation is required.

• The time frame for which patients should be asked to assess their nausea/vomiting, pain, and fatigue is the week prior to the chemotherapy encounter;

• The $130 demonstration fee should be divided for billing purposes as follows

G9021 –G9024 (Select code for nausea/vomiting) $43.34

G9025 – G9028 (Select code for pain) $43.33

G9029 –G9032 (Select code for fatigue) $43.33

• The demonstration program does not apply to beneficiaries enrolled in Medicare Advantage.

Please continue to check back to the ASH Web site for new updates.