Medicare Modernization Act (MMA) Drug Payment Limits Pricing Files

Guidance for Medicare Modernization Act (MMA) Drug Payment Limits Pricing Files For Dates of Service 1/1/2004 and After

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 11, 2020

Medicare Modernization Act (MMA) Drug Payment Limits Pricing Files For Dates of Service 1/1/2004 and After - Revised 1/30/04

The following files are located in the Downloads section below:

HCPCS Drug Pricing File - Updated 10/01/04
NOTE: The revision includes the changes identified in the following CRs:
CR3161 - Published 3/15/04
CR3312 - Published 6/25/04
CR3419 - Published 8/24/04
CR3418 - Published 8/27/04

FI Specific HCPCS Drug Pricing File

HCPCS Drug Pricing Background File for Other than ESRD-Related or DME Infusion Drugs - Updated 6/17/04

HCPCS Drug Pricing Background File for ESRD Drugs - Updated 6/17/04

HCPCS Drug Pricing Background File for DME Infusion Drugs

NOC Drug Pricing

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.