US · guidance
CMS Pub. 100-04, ch. 17, § 20.5.1
Background
Payment for drugs and biologicals under Medicare is determined by a standard methodology. Law and
regulations require that a drug payment allowance limit be used as described in §20.1. (See 42 CFR
405.517 and MPDIMA, Section 303(b).)
The earliest drug payment allowance limit effective in 2004 will not be subsequently updated during 2004.
When limits are initially established, A/B MACs (B) inform A/B MACs (A) and the provider community
as described in paragraph §30 below.
History
(Rev. 397, Issued: 12-16-04, Effective: 01-01-05, Implementation: 01-03-05)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
04a186cfaea60c3e4128dc871d254089b8efd633e5bad7943b8fc029df53b593
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