REVISED 2023 Quarterly Physician Drug Code Rate Updates Implemented

Mar 15, 2024

The Department updated the Physician Drug Rates in alignment with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate updates for 2023. The updated rates can be found on the Health PAS Online Portal and were implemented for billing on the following dates:

Q1 - Implemented on 3/8/2023 (CR 114866)

Revised and implemented on 9/20/2023 (CR 119912)

Code	Rate	Start Date	End Date
J7196	$103.35	1/1/2023	12/31/2078
J7503	$1.62	1/1/2023	12/31/2078
J7517	$0.22	1/1/2023	3/31/2023
J7674	$0.69	1/1/2023	3/31/2023
J9015	$3,628.26	1/1/2023	12/31/2078
J9032	$46.15	1/1/2023	3/31/2023
J9176	$7.06	1/1/2023	12/31/2078
J9263	$0.08	1/1/2023	3/31/2023
J9307	$339.33	1/1/2023	3/31/2023
J9328	$10.41	1/1/2023	3/31/2023
J9349	$13.15	1/1/2023	12/31/2078
Q2026	$167.36	1/1/2023	12/31/2078
Q2028	$1.02	1/1/2023	12/31/2078
Q5111	$137.66	1/1/2023	3/31/2023
Q9967	$0.17	1/1/2023	12/31/2078

 

Q2 - Implemented on 5/3/2023 (CR116789)

Q3 - Implemented on 8/2/2023 (CR 118827)

Revised and implemented on 11/15/2023 (CR121125)

Code	Rate	Start Date	End Date
J0585	$6.35	7/1/2023	9/30/2023
J7311	$340.23	7/1/2023	9/30/2023
J8655	$419.56	7/1/2023	9/30/2023
Q4133	$145.42	7/1/2023	9/30/2023

 

Q4 – Implemented on 11/15/2023 (CR 121125)

Adjustment of Claims

The Department will adjust claims that were submitted at or above the new rates for dates of service noted below:

Q1: 1/01/2023 - 3/07/2023

                        Revised Q1: 1/1/2023 -9/19/2023

Q2: 4/01/2023 - 5/02/2023

Q3: 7/01/2023 - 8/01/2023

                        Revised Q3: 7/1/2023 – 9/30/2023

Q4: 10/01/2023 - 11/14/2023

For questions, please contact your Provider Relations Specialist.