Part B Insider (Multispecialty) Coding Alert

Published on Sat Oct 30, 2004 PDF

GAO backs providers gasping over cuts to inhalation

If you've been worried about sharp cuts to inhalation drug payments without anything to counterbalance them, breathe easier. In response to a Government Accountability Office report recommending an appropriate dispensing fee, the Centers for Medicare & Medicaid Services says it is planning a fee of $55 to $64 per month in 2005.

That level of fee should avert most potential access problems caused by the drastic payment rate cut to albuterol sulfate and ipratropium bromide, says Phil Porte, executive director of the National Association for Medical Direction of Respiratory Care. The GAO found a wide range of dispensing costs for the drugs when it analyzed data from 12 inhalation therapy suppliers, ranging from $7 to $204 a month in 2003.