US · guidance
CMS Pub. 100-04, ch. 17, § 100.4.7
CAP Fee Schedule
CMS will provide a fee schedule for the payment of CAP drugs to the designated A/B
MAC (B) and MCS. The fees will be provided in a file on the CMS mainframe at a later
date. The file layout is attached.
CAP PROGRAM FEE SCHEDULE FILE RECORD DESCRIPTION
Field Name Position Length Format Description
HCPCS 1-5 5 Character Healthcare Common Procedure
Coding System
Filler 6-7 2 Space Filled
State 8-9 2 Character Alpha Abbreviation
Filler 10-11 2 Space Filled
Current Year 12-15 4 Character YYYY
Filler 16-17 2 Space Filled
Current
Quarter
18 1 Character Calendar Quarter - value 1-4
Filler 19-20 2 Space Filled
Fee 21-29 9 Numeric Fee to Pay For Drug
$$$$$$¢¢¢(Pic9(6)v999)
Filler 30-80 51 Character Space Filled
CMS will upload the CAP Part B Drug file to the Direct Connect each calendar quarter.
Approximately six weeks prior to the beginning of each calendar quarter (i.e.,
approximately 6 weeks prior to January 1, April 1, July 1, and October 1) an email will
be sent out providing notification of the availability of the updated file. The updated file
will be available in the early November for the January 1 release, early February for the
March 1 release, early May for the July 1 release, and early August for the September 1
release.
History
(Rev. 1055, Issued: 09-11-06; Effective: 10-01-06; Implementation: 10-02-06)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
3083fc5c636edf9db173c1cea4518f4497ff672ac3ab2bf229cfb1dae4250fbb
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.