Medicare Claims Processing- Transmittal 119
Guidance for plans regarding pricing information for those drugs exempted from the default 85 percent used in the general calculation for determining the payment limits for Medicare Part B covered drugs and biologicals not paid on a cost or prospective payment basis. It also includes a list of the HCPCS drug codes exempted from the default 85 percent and the GAO/OIG studies used in the general calculation for determining the payment limits for Medicare Part B covered drugs and biologicals not paid on a cost or prospective payment basis. .
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 15, 2004
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