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Overview

Manufacturer reporting of Average Sales Price (ASP) data

A manufacturer's ASP must be calculated by the manufacturer every calendar quarter and submitted to CMS within 30 days of the close of the quarter.  Each report must be certified by one of the following: the manufacturer's Chief Executive Officer (CEO); the manufacturer's Chief Financial Officer (CFO); an individual who has delegated authority to sign for, and who reports directly to, the manufacturer's CEO or CFO.

Manufacturers must report the ASP data to us in Microsoft Excel using the template provided in Addendum A, the ASP Data Form.  Both this and the ASP Certification Form (Addendum B), are available in the 'Downloads' section below. 

When sending ASP data to CMS via first class mail, federal express mail, or overnight delivery, please use the following address:

Centers for Medicare & Medicaid Services
Hospital and Ambulatory Policy Group
Division of Ambulatory Services
ATTN: Medicare ASP Data
Mail Stop No. C4-01-26
7500 Security Boulevard
Baltimore, MD 21244
Phone: 410-786-0548

Please send any questions to: sec303aspdata@cms.hhs.gov.

Medicare Contractor Reporting Template for Medicare Part B Drugs - (Located in the "Downloads" section below)

As indicated in CR 4140, dated February 15, 2006, Medicare contractors shall use the Medicare Contractor Reporting Template for Part B drugs to report information on all Medicare Part B drugs not paid on a cost or prospective payment basis when payment limits are not listed in the quarterly drug pricing files, or in the OPPS Pricer. Contractors shall also use the template to report pricing information for the NOC drug billing codes. This information must be sent to CMS on a monthly basis to e-mail address: sec303aspdata@cms.hhs.gov.

New Information Regarding Medicare Payment and Coding for Drugs and Biologics (See Downloads section below for the message)

Section 303(c) of the Medicare Modernization Act of 2003 (MMA) revised the payment methodology for Part B covered drugs that are not paid on a cost or prospective payment basis. In particular, section 303(c) of the MMA amended Title XVIII of the Act by adding section 1847A, which established a new average sales price (ASP) drug payment system.  Beginning January 1, 2005, drugs and biologicals not paid on a cost or prospective payment basis will be paid based on the ASP methodology, and payment to the providers will be 106 percent of the ASP.  There are exceptions to this general rule which are listed in the latest ASP quarterly change request (CR) document.  The ASP methodology uses quarterly drug pricing data submitted to the CMS by drug manufacturers.  CMS will supply contractors with the ASP drug pricing files for Medicare Part B drugs on a quarterly basis.

 

Downloads
Medicare Contractor Reporting Template for Medicare Part B Drugs [ZIP, 5KB]

5/18/07 - Update to Information Regarding Medicare Payment and Coding for Drugs and Biologics [PDF, 21KB]

4/25/07 -Update to Information Regarding Medicare Payment and Coding for Drugs & Biologics [PDF, 22KB]

New Information Regarding Medicare Payment and Coding for Drugs and Biologics [PDF, 11KB]

ASP Data Form (Addendum A) – Revised 2009 [Excel zipped, 27KB]

ASP Certification Form (Addendum B) – Revised 2009 [PDF, 13KB]

List of drugs supplied under the CAP, corresponding NDCs, CAP Payment Amounts and Vendor VIN [PDF, 240KB]

Related Links Inside CMS

Details for RTC-Sales of Drugs and Biologicals to Large Volume Purchasers

Medicare Replacement Drug Demonstration

Competitive Acquisition for Part B Drugs & Biologicals

Frequently Asked Questions
Related Links Outside CMSExternal Linking Policy

There are no Related Links Outside CMS

 

Page Last Modified: 10/14/2009 8:01:47 AM
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