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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