CMS Announces New Policy for Biosimilars Payments Under Part B

As we previously reported, the Centers for Medicare and Medicaid Services (“CMS”) has been considering comments on a proposed rule regarding biosimilar payment policies.

On Thursday, CMS issued a final rule for the 2018 Physician Fee Schedule, which includes a change to the biosimilar payment policy.  Prior to the issuance of this rule, CMS assigned biosimilar products the same billing and payment code as other biosimilars referencing the same RLP.  Noting that in 2015 biological products accounted for the majority of spending under Medicare Part B totaling $26 billion, under the final rule CMS will separately code and pay for biosimilar products under Part B.  CMS stated that this “change promotes competition to ensure millions of patients will have access to new lower cost therapies.”