We also proposed to revise 427.302(d)(1)(ii) by removing If neither a published payment limit nor manufacturer-reported ASP or WAC data are available, CMS will use WAC data from other public sources to calculate 106 percent of WAC, which, solely for the purposes of this section, CMS will consider to be the payment amount for the payment amount benchmark quarter. If a published payment limit is not available for the applicable payment amount benchmark quarter, at 427.302(d)(1)(i), we proposed to calculate the payment amount in the payment amount benchmark quarter using positive ASP or positive WAC data reported by manufacturers to the ASP Data Collection System
Superficial Radiation Therapy (CPT Codes 77X05, 77X07, 77X08, and 77X09) Superficial radiation therapy is currently provided using CPT code 77401 ( Radiation treatment delivery, superficial and/or ortho voltage, per day ) in conjunction with CPT code 77280 ( Therapeutic radiology simulation-aided field setting
(2) Moderate: some RCTs or large cohort studies
As access to biosimilar alternatives grows, monitoring and care standards will remain vital in delivering optimal outcomes
Calabrese et al., 2021
