Advocacy & Practice Updates — Clinical Updates

Higher Medicare Add-On Payment for Biosimilars Effective October 1

Late last week, CMS released guidance on increased add-on payments for biosimilar drugs administered under Medicare Part B as required by the recently passed Inflation Reduction Act. Beginning October 1, 2022, Medicare will reimburse physicians average sales price (ASP) plus 8% on qualifying biosimilar Part B drugs. Qualifying biosimilars are defined as those whose ASP is lower than the reference drug’s. The increased add-on payment will be in place through calendar year 2027. 

(Published 9.28.22)