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US · guidance

CMS Pub. 100-04, ch. 17, § 90.3

Hospital Outpatient Payment Under OPPS for New, Unclassified

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

Drugs and Biologicals After FDA Approval But Before Assignment of a

Product-Specific Drug or Biological HCPCS Code

(Rev. 3085, Issued: 10-03-14, Effective: ICD-10: Upon Implementation of ICD-10; ASC X12: January 1, 2012, Implementation: ICD-10: Upon Implementation of ICD- 10; ASC X12: November 4, 2014)

Section 621(a) of the MMA amends Section 1833(t) of the Social Security Act by adding

paragraph (15), Payment for New Drugs and Biologicals Until HCPCS Code Assigned.

Under this provision, payment for an outpatient drug or biological that is furnished as

part of covered outpatient department services for which a product-specific HCPCS code

has not been assigned shall be paid an amount equal to 95 percent of average wholesale

price (AWP). This provision applies only to payments under the hospital outpatient

prospective payment system (OPPS).

Beginning January 1, 2004, hospital outpatient departments may bill for new drugs and

biologicals that are approved by the FDA on or after January 1, 2004, for which a

product-specific HCPCS code has not been assigned. Beginning on or after the date of

FDA approval, hospitals may bill for the drug or biological using HCPCS code C9399,

Unclassified drug or biological.

Hospitals report in the ASC X12 837 institutional claim format in specific locations, or in

the “Remarks” section of Form CMS-1450):

• the National Drug Code (NDC),

• the quantity of the drug that was administered, expressed in the unit of measure

applicable to the drug or biological, and

• the date the drug was furnished to the beneficiary.

Contractors shall manually price the drug or biological at 95 percent of AWP. They shall

pay hospitals 80 percent of the calculated price and shall bill beneficiaries 20 percent of

the calculated price, after the deductible is met. Drugs and biologicals that are manually

priced at 95 percent of AWP are not eligible for outlier payment.

HCPCS code C9399 is only to be reported for new drugs and biologicals that are

approved by FDA on or after January 1, 2004, for which there is no HCPCS code that

describes the drug.

History

(Rev. 3085, Issued: 10-03-14, Effective: ICD-10: Upon Implementation of ICD-10; ASC X12: January 1, 2012, Implementation: ICD-10: Upon Implementation of ICD- 10; ASC X12: November 4, 2014)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
223975c6210aa3a0fcce2b93b5cbd6621e1118e0c93fc0594a9949fec6586a90
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