Additional Drug Rate Updates, CR 106867

Mar 09, 2023

Due to the Centers for Medicare & Medicaid Services’ (CMS) rate update, we updated the rates for some drug codes retroactively to January 1, 2021, or July 1, 2021.   

See the table below for the effective dates and rates.   

Procedure Code	Start Date	End Date	Rate = $
J2353	1/1/2021	3/31/2021	$205.41
J2353	7/1/2021	9/30/2021	$203.94
J7518	7/1/2021	9/30/2021	$1.46

 

Adjustments for affected claims:   

If you billed these codes at a higher rate than is indicated in the table above, we will reprocess your claims and no provider action is needed.     

If you billed these codes at a lower rate than is indicated in the table above, please adjust the affected claims. Providers have 120 days from the date of this notice to submit corrected adjustments; please focus on the older dates of service first.    

Please contact your Provider Relations Specialist with questions.