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 here.