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US · guidance

CMS Pub. 100-04, ch. 13, § 30.1.2

Payment Level

activein force · 2026-08-25 – presentas-observed

Determine payment in the same manner as for a drug furnished incident to a physician’s service.

The payment methodology for LOCM for the period of January 1, 2005 through March 31, 2005 is made

in accordance with the established payment for calendar year 2004 using codes A4644-A4646.

Effective April 1, 2005, the method of payment for LOCM is the average sales price (ASP) plus six

percent in accordance with the standard methodology for drug pricing established by the Medicare

Modernization Act (MMA0 for other than hospital outpatient claims. Payments for the new Q codes can

be found in the respective quarterly Medicare Part B drug pricing files that are posted on the CMS Web

site.

History

(Rev. 627, Issued: 07-29-05, Effective: 01-01-05, Implementation: 10-31-05)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
d5570cfbb0c7f840ea109ff9a7d596a799593c61fddd2561a694986a7901a7b5
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