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User Enhancement Change Request (UECR): ViPS Medicare System (VMS) – Process Change for ZIP Code Price Method of the Quarterly ZIP Code Update

The purpose of this Change Request (CR) is to develop a process with the Quarterly ZIP Code load, like the load process for Drug Pricing (APPL/C) file, where the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) can indicate the Pricing Period where the Pricing Methods on ZIP Code file are to be loaded. With the altered load process, the DME MACs will be able to keep the Pricing Periods in the VMAP/4Z table and APPL/C in sync so that drug claims do not reimburse at the wrong amount. The DME MACs will have the ability to pinpoint the pricing period in which to populate the Pricing Methods on the file.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 10, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.