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July 3, 2024

Insulin Fee Schedule Reduced July 1, 2024

CGS is alerting suppliers and providers about a significant drop in the fee schedule for insulin HCPCS code J1817 (Insulin for administration through DME (i.e., insulin pump) per 50 units). The 2024 third quarter (July 1 – September 30) fee amount for J1817 is $2.539 compared to $7.595 during the second quarter.

The decrease is the result of insulin manufacturers reducing their prices in 2023 by 70-75%. Because of the lag in ASP pricing, the lower prices are reflected in the Medicare fee schedules now.

View the CMS ASP Pricing Files hereExternal Website.


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