REVISED 2023 Quarterly Physician Drug Code Rate Updates Implemented

The Department updated the Physician Drug Rates in alignment with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate updates for 2023. The updated rates can be found on the Health PAS Online Portal and were implemented for billing on the following dates:

Q1 - Implemented on 3/8/2023 (CR 114866)

Revised and implemented on 9/20/2023 (CR 119912)

Code

Rate

Start Date

End Date

J7196     

$103.35

1/1/2023

12/31/2078

J7503     

$1.62

1/1/2023

12/31/2078

J7517     

$0.22

1/1/2023

3/31/2023

J7674     

$0.69

1/1/2023

3/31/2023

J9015     

$3,628.26

1/1/2023

12/31/2078

J9032     

$46.15

1/1/2023

3/31/2023

J9176     

$7.06

1/1/2023

12/31/2078

J9263     

$0.08

1/1/2023

3/31/2023

J9307     

$339.33

1/1/2023

3/31/2023

J9328     

$10.41

1/1/2023

3/31/2023

J9349     

$13.15

1/1/2023

12/31/2078

Q2026     

$167.36

1/1/2023

12/31/2078

Q2028     

$1.02

1/1/2023

12/31/2078

Q5111     

$137.66

1/1/2023

3/31/2023

Q9967     

$0.17

1/1/2023

12/31/2078

 

Q2 - Implemented on 5/3/2023 (CR116789)

Q3 - Implemented on 8/2/2023 (CR 118827)

Revised and implemented on 11/15/2023 (CR121125)

Code

Rate

Start Date

End Date

J0585

$6.35

7/1/2023

9/30/2023

J7311

$340.23

7/1/2023

9/30/2023

J8655

$419.56

7/1/2023

9/30/2023

Q4133

$145.42

7/1/2023

9/30/2023

 

Q4 – Implemented on 11/15/2023 (CR 121125)

Adjustment of Claims

The Department will adjust claims that were submitted at or above the new rates for dates of service noted below:

Q1: 1/01/2023 - 3/07/2023

                        Revised Q1: 1/1/2023 -9/19/2023

Q2: 4/01/2023 - 5/02/2023

Q3: 7/01/2023 - 8/01/2023

                        Revised Q3: 7/1/2023 – 9/30/2023

Q4: 10/01/2023 - 11/14/2023

For questions, please contact your Provider Relations Specialist.  

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