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US · guidance

CMS Pub. 100-04, ch. 17, § 30

A/B MAC (B) Distribution of Limit Amounts

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

The A/B MACs (A) get drug prices from the A/B MAC (B) for drugs not listed on the SDP.

A/B MACs (B) prepare a list of the drug payment allowance limits updates (or new file depending upon

local requirements) to the claims system.

A/B MACs (B) distribute, free of charge, the updated limits in an agreed upon format directly to the

A/B MACs (A) in their jurisdiction.

A/B MACs (B) should contact each A/B MAC (A) to determine the preferred method of transmission.

A/B MACs (B) are to send this information to all A/B MACs (A) they routinely deal with. If this

method of obtaining payment allowance updates does not work for any A/B MAC (A), the A/B MAC

(B) must contact the appropriate RO office.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
80d6e6a465613c95de0e22662623075addfeafa6af79db338728c7279ef9e0e7
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