- Coding & Pricing
Medicare Reimbursement Rate
Centers for Medicare & Medicaid Services (CMS) has updated the reported Medicare reimbursement rate for ALOXI® (palonosetron HCl) injection - J2469 - Effective January 1, 2012.
1st Quarter 2012 ALOXI® Medicare reimbursement in the Physician Office setting is
$18.467 per 25 mcg1, and in the Hospital Outpatient setting is $18.12 per 25 mcg.2
These payment rates are in effect from January 1, 2012 through
March 31, 2012.1
Medicare payment for most drugs administered in the physician office setting is based on the drug's Average Sales Price (ASP) + 6%.1
Medicare payment for non pass-through, separately payable drugs administered in the hospital outpatient setting is based on the drug's Average Sales Price (ASP) + 4%.2
ASP rates are recalculated and released on a quarterly basis by CMS but can be updated more frequently. Please visit the CMS website below for the most up to date information.
For additional information and assistance with ALOXI®, please contact the Eisai Assistance Program at 1-866-61-EISAI or 1-866-61-34724, Monday through Friday from 8:00 A.M. to 8:00 P.M. (Eastern Time).
Medicare Reimbursement Rate – Physician Office
References
1. Centers for Medicare & Medicaid Services Web Site, Medicare, Medicare Part B Drugs Average Sales Price, 2012 ASP Drug Pricing Files, January 2012 ASP Pricing File – Updated December 9, 2011. Accessed on December 13, 2011 at this address: http://www.cms.gov/McrPartBDrugAvgSalesPrice/01a17_2012ASPFiles.asp#TopOfPage. Rates are subject to change.
2. Centers for Medicare & Medicaid Services Web Site, Medicare, Hospital Outpatient PPS, 2012 January Addendum B, Updated December 28, 2011. Accessed on January 2, 2012 at this address: http://www.cms.gov/HospitalOutpatientPPS/AU/list.asp#TopOfPage. Rates are subject to change.
