{"DID":"crit1a4b5d","Sites":"Railroad Medicare","Start Date":"05-23-2024 00:00","End Date":"05-27-2024 23:27","Content":"The Palmetto GBA Railroad Medicare Provider Contact Center (PCC) will be closed on Monday, May 27, 2024, in observance of the Memorial Day holiday.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit1b1dee","Sites":"Railroad Medicare","Start Date":"12-29-2021 12:07","End Date":"12-31-2021 16:00","Content":"The Palmetto GBA Railroad Medicare Provider Contact Center (PCC) will be closed on December 31, 2021, in observance of the New Year's Day holiday.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n"}, {"DID":"crit21c51d","Sites":"Railroad Beneficiaries^Railroad Medicare","Start Date":"12-21-2022 08:17","End Date":"12-26-2022 17:00","Content":"The Palmetto GBA Railroad Medicare Beneficiary Contact Center (BCC) will be closed on December 23 and 26, 2022, in observance of the Christmas holidays.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit23bc4e","Sites":"Railroad Medicare","Start Date":"03-20-2024 08:21","End Date":"03-31-2024 08:21","Content":"Join us for Spring Tour 2024: Columbia S.C. on April 2, 2024.","URL":"https://web.cvent.com/event/742e000a-81da-44bb-a8b9-e63fa849446c/summary","Target":"_blank","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit25d22d","Sites":"Railroad Beneficiaries^Railroad Medicare","Start Date":"06-29-2022 12:31","End Date":"07-05-2022 00:00","Content":"The Palmetto GBA Railroad Medicare Beneficiary Contact Center (BCC) will be closed on Monday, July 4, 2022, in observance of the Independence Day holiday.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit2b4d1e","Sites":"Railroad Medicare","Start Date":"12-30-2022 11:30","End Date":"01-02-2023 18:30","Content":"The Palmetto GBA Railroad Medicare Provider Contact Center (PCC) will be closed Monday, January 2, 2023, in observance of New Year's Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit32dc33","Sites":"Railroad Beneficiaries^Railroad Medicare","Start Date":"09-01-2023 11:13","End Date":"09-04-2023 17:13","Content":"The Palmetto GBA Railroad Medicare Provider Contact Center (PCC) will be closed Monday, September 4, 2023, in observance of Labor Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit34dea1","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"07-22-2024 08:25","End Date":"07-22-2024 08:30","Content":"Web chat is unavailable due to a system outage. We are working to resolve the issue and will remove this banner once the system is available.","URL":"","Target":"_self","Color":"red","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit3c4dd4","Sites":"Railroad Medicare","Start Date":"05-03-2023 08:42","End Date":"05-09-2023 07:00","Content":"The Railroad Medicare Provider Contact Center will be closed on Monday, May 8, 2023 due to a planned system transition. The Railroad Medicare IVR and eServices portal will also be unavailable on this day. Service is expected to be restored to all areas on Tuesday, May 9, 2023.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit3c53c3","Sites":"Railroad Medicare","Start Date":"02-26-2023 06:00","End Date":"02-28-2023 13:15","Content":"Railroad Medicare: Provider Enrollment, Electronic Data Interchange Basics Webinar: February 28, 2023, 1PM EST","URL":"https://event.on24.com/wcc/r/4108960/0EE03B2682B0A66F61916D8691AA1A00","Target":"_blank","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit3d3234","Sites":"Railroad Medicare","Start Date":"05-27-2022 13:36","End Date":"05-30-2022 21:36","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, May 30, 2022, in observance of Memorial Day","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit4d5bec","Sites":"Railroad Medicare","Start Date":"01-03-2024 14:43","End Date":"01-06-2024 14:43","Content":"Due to a system issue identified January 3, 2024, payments dated January 4 and January 5, 2024, will be delayed. Claims and payments originally scheduled for payment these days will now be paid January 8, 2024.","URL":"","Target":"_self","Color":"yellow","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit4db3bb","Sites":"Railroad Medicare","Start Date":"09-30-2024 10:26","End Date":"10-05-2024 10:26","Content":"Due to the effects of Hurricane Helene, calls to our provider contact center may experience longer wait times than usual.","URL":"","Target":"_self","Color":"yellow","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit5b152d","Sites":"JJA^JJB^JMA^JMB^Railroad Medicare","Start Date":"09-02-2024 18:00","End Date":"09-22-2024 08:36","Content":"Registration is open for the 2024 MACtoberfest education event in Columbia, S.C. Please plan to attend.","URL":"https://web.cvent.com/event/4c4a964e-0c1a-45a8-a4d4-9d8ead85dc11/summary","Target":"_blank","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit5b5a21","Sites":"Railroad Medicare","Start Date":"05-28-2024 00:00","End Date":"05-28-2024 23:27","Content":"Railroad Medicare providers are invited to Palmetto GBA's MayFest virtual education event Thursday May 30, 2024. ","URL":"https://palmettogba.com/palmetto/rr.nsf/DIDC/8DRB9MA2C9~Events%20and%20Education","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critbcc5ea","Sites":"Railroad Medicare","Start Date":"12-21-2022 08:17","End Date":"12-26-2022 17:00","Content":"The Palmetto GBA Railroad Medicare Provider Contact Center (PCC) will be closed on December 23 and 26, 2022, in observance of the Christmas holiday.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critc11542","Sites":"Railroad Medicare","Start Date":"06-26-2024 12:38","End Date":"07-04-2024 22:00","Content":"The Palmetto GBA Railroad Medicare Provider Contact Center (PCC) will be closed Thursday, July 4, 2024, in observance of Independence Day.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critcd1cce","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"09-16-2024 10:40","End Date":"09-16-2024 12:00","Content":"The eServices portal is currently unavailable. We are working to resolve the issue and will remove this banner once the portal is available.","URL":"","Target":"_self","Color":"red","Mode":"Standard\n","Priority":"no"}, {"DID":"critcd5b1b","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"09-16-2024 12:17","End Date":"09-16-2024 14:00","Content":"Currently, the eServices portal is intermittently unavailable. We are working to resolve the issue and will remove this banner once functionality is restored.","URL":"","Target":"_self","Color":"red","Mode":"Standard\n","Priority":"yes"}, {"DID":"crite35ca3","Sites":"Railroad Beneficiaries^Railroad Medicare","Start Date":"02-16-2024 14:21","End Date":"02-16-2024 16:30","Content":"The Palmetto GBA RRB SMAC Provider Contact Center (PCC) will be open and available to take your calls on President's Day, Monday, February 19, 2024.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}

Drugs and Biologicals

Published 6/1/2016

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)

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