Category Archives: ReimbursementCodes

INSIDE THIS ISSUE Drug Reimbursement Code Price Updates Drugs/Devices -New Clinical and Billing Information CMS News -New, Revised, and Deleted HCPCS® Codes Now Available -New CPT® Codes Now Available -Quarterly ASP (Average Sales Price) Pricing File Released -January 2021 NOC (Not Otherwise Classified) Pricing File -Hospital OPPS (Outpatient Prospective Payment System) Update Clinical News CODE […]

INSIDE THIS ISSUE Drug Reimbursement Code Price Updates Drugs/Devices -New Clinical and Billing Information CMS News -2021 HCPCS® File -Coronavirus Vaccines and Treatment Response Clinical News CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. […]

INSIDE THIS ISSUE Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CMS News Clinical News CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of the 63 AWP Drug Code Price changes […]

INSIDE THIS ISSUE Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Clinical News 2020-2021 Influenza Vaccine Season NDCs Now Available J7304 Updated to NDC Level Pricing CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale […]

A few of RJ Health’s subject matter experts held webinar sessions to talk about controlling medical drug spend as well as the different challenges a pharmaceutical organization may run into when launching or updating a drug. Full recordings of the sessions are now available. Choose a session below:

The following questions were submitted by attendees during the most recent Quarterly Drug Coding, Reimbursement, and Pipeline Update Webinar for Q3 2019. or      Q:  On the “Pricing Updates” slide it shows that the majority of Code Price changes were increases, but the Medicare Allowable ASP price changes showed a majority which were decreases. Why […]

INSIDE THIS ISSUE CMS News 2019-2020 Influenza Vaccine Season NDCs Now Available New HCPCS Drug Q-Codes effective October 1, 2019 New HCPCS Drug J-Codes effective October 1, 2019 New HCPCS Drug Code Revisions and Discontinuations effective October 1, 2019 Drug Reimbursement Code Price Updates 48 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices […]

Have questions about how drugs are priced? Wondering which pricing methodologies apply to your drug claim? Curious about the origins of the various types of drug codes? Join RJ’s Product and Clinical teams as they walk through the multitude of different combinations of drug claims and pricing methodologies, via clips from the webinar “Shedding Light […]

Many payors have incorporated policies for providers to inform payors on discarded or wastage amounts of drugs in single-use packages. To ensure appropriate reimbursement, the providers are required to submit two claim lines for the administered drug.  One claim line reflects the dosage administered to the patient and the second is for the wastage amount. […]

  Is your organization ready to recapture some of the $3 Billion lost each year to drug wastage? Have single-dose vials, dose, and waste, created a reimbursement challenge? What is drug wastage? How does drug wastage occur? What is the size and scope of drug wastage? Who does drug wastage impact? How can drug wastage be addressed? […]