Retro Physician Drug Rate Updates: Effective October 1, 2023, through September 30, 2024, CR 127535
The Department updated multiple physician drug codes retroactively due to a rate update from the Centers for Medicare & Medicaid Services’ (CMS). These new rates were implemented on October 23, 2024.
See the table below for the effective dates and new rates.
|
Procedure Code |
Start Date |
End Date |
Current Rate |
Revised Rate |
|
J1817 |
7/1/2024 |
9/30/2024 |
$2.54 |
$2.45 |
|
J7606 |
7/1/2024 |
9/30/2024 |
$3.15 |
$3.20 |
|
J7613 |
7/1/2024 |
9/30/2024 |
$0.05 |
$0.07 |
|
J7614 |
7/1/2024 |
9/30/2024 |
$0.05 |
$0.08 |
|
J7677 |
7/1/2024 |
9/30/2024 |
$0.18 |
$0.19 |
|
J9317 |
10/1/2023 |
12/31/2023 |
$33.26 |
$33.11 |
|
J9317 |
1/1/2024 |
3/31/2024 |
$34.08 |
$33.95 |
|
J9317 |
4/1/2024 |
6/30/2024 |
$34.10 |
$33.87 |
|
J9317 |
7/1/2024 |
9/30/2024 |
$34.93 |
$34.69 |
Adjustments for affected claims:
The Department will reprocess claims submitted with charges at or above the rates indicated in the table above. No provider action is required.
For questions, please contact your Provider Relations Specialist.
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