Skip to Main Content

{"DID":"crit15d1eb","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"07-27-2023 07:43","End Date":"07-28-2023 13:01","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, July 28, 2023, for staff training.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit2114dd","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-23-2023 10:46","End Date":"08-25-2023 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, August 25, 2023, for staff training.\n","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit32a323","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"06-14-2023 15:04","End Date":"06-16-2023 17:30","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed for an eight-hour staff training on Friday, June 16, 2023.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit34c5e3","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"03-24-2023 08:40","End Date":"03-26-2023 12:00","Content":"eServices eAudit data is currently unavailable. We are working to resolve this issue and will remove this message when functionality is restored.","URL":"","Target":"_self","Color":"yellow","Mode":"Standard\n","Priority":"no"}, {"DID":"crit4334e1","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"07-11-2023 15:05","End Date":"07-14-2023 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, July 14, 2023, for staff training.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit44c243","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-16-2023 14:38","End Date":"11-24-2023 18:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed November 23 and 24, 2023, in observance of the Thanksgiving holiday.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crita42d51","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-31-2023 15:00","End Date":"09-04-2023 17:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, September 4, 2023, in observance of Labor Day.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crita54bdb","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"05-24-2023 13:47","End Date":"05-29-2023 18:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, May 29, 2023, in observance of Memorial Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crita5c5ba","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-08-2023 10:22","End Date":"11-10-2023 22:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed for an 8-hour training on Veterans Day, Friday, November 10, 2023.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"critbca1cd","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-28-2023 13:50","End Date":"11-28-2023 20:18","Content":"The Provider Contact Center (PCC) has closed for today, November 28, 2023, due to technical issues. The PCC will resume taking calls tomorrow during normal business hours. We apologize for the inconvenience and appreciate your patience. ","URL":"","Target":null,"Color":"red","Mode":"Standard\n","Priority":"yes"}, {"DID":"critce3553","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"09-13-2023 13:16","End Date":"09-15-2023 12:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, September 15, 2023, for staff training","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critd1a1c4","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"06-29-2023 09:58","End Date":"07-04-2023 17:30","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Tuesday, July 4, 2023, in observance of Independence Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critd33c3a","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-28-2023 13:50","End Date":"12-01-2023 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, December 1, 2023, for staff training.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critdbc2e4","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"10-05-2023 13:16","End Date":"10-09-2023 17:30","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed for an 8-hour training on Columbus Day, Monday, October 9, 2023.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}

Drugs and Biologicals

Published 12/01/2016

Access guidance for submitting drugs and biologicals through the links below.

Reimbursement

Average Sales Price (ASP) and Not Otherwise Classified (NOC) Pricing Files
Wholesale Acquisition Cost (WAC) Pricing (PDF, 493 KB) CMS Medicare Claims Processing Manual, Chapter 17, Section 20.1.3
- Note: This applies to drugs that are not reimbursed based on the ASP or NOC pricing files

Claim Submission and Guidelines

Allergy Testing and Immunotherapy (PDF, 1.15 MB) CMS Medicare Claims Processing Manual (Pub. 100-04), Chapter 17, Section 200
Discarded Drugs and Biologicals (PDF, 493 KB) CMS Medicare Claims Processing Manual (Pub. 100-04), Chapter 17, Sections 40 and 100.2.9
General Guidance Regarding Drugs and Biologicals (PDF, 1.42 MB) CMS Medicare Benefit Policy Manual (Pub. 100-02), Chapter 15, Section 50-50.6
Mandatory Assignment on Carrier Claims (PDF, 1.63 MB) CMS Medicare Claims Processing Manual (Pub. 100-04), Chapter 1, Section 30.3.1
Payment for Codes for Chemotherapy Administration and Nonchemotherapy Injections and Infusions (PDF, 1.15 MB) Medicare Claims Processing Manual (Pub. 100-04), Chapter 12, Section 30.5)

Was this article helpful?