CAP Fee Schedule

100.4.7 - CAP Fee Schedule (Rev. 1055, Issued: 09-11-06; Effective: 10-01-06; Implementation: 10-02-06) CMS will provide a fee schedule for the payment of CAP drugs to the designated A/B MAC (B) and MCS. The fees will be provided in a file on the CMS mainframe at a later date. The file layout is attached. CAP PROGRAM FEE SCHEDULE FILE RECORD DESCRIPTION Field Name Position Length Format Description HCPCS 1-5 5 Character Healthcare Common Procedure Coding System Filler 6-7 2 Space Filled State 8-9 2 Character Alpha Abbreviation Filler 10-11 2 Space Filled Current Year 12-15 4 Character YYYY Filler 16-17 2 Space Filled Current Quarter 18 1 Character Calendar Quarter - value 1-4 Filler 19-20 2 Space Filled Fee 21-29 9 Numeric Fee to Pay For Drug $$$$$$¢¢¢(Pic9(6)v999) Filler 30-80 51 Character Space Filled CMS will upload the CAP Part B Drug file to the Direct Connect each calendar quarter. Approximately six weeks prior to the beginning of each calendar quarter (i.e., approximately 6 weeks prior to January 1, April 1, July 1, and October 1) an email will be sent out providing notification of the availability of the updated file. The updated file will be available in the early November for the January 1 release, early February for the March 1 release, early May for the July 1 release, and early August for the September 1 release.