Compounding gets new codes

Sunday, December 31, 2006

COLUMBIA, S.C. - Medicare released new codes--but no fee schedules--for compounded neb meds, making it difficult to gauge the potential impact on the industry.
Starting in January 2007, compounded versions of levalbuterol, albuterol, budesonide, ipratroprium and other inhalation drugs will be billed under separate HCPCS codes based on the average sales price of active ingredients, rather than the rates for commercially available versions.
Despite not knowing the new fee schedule yet, compounding pharmacies should expect lower margins, said Mickey Letson, president of Decatur, Ala.-based Letco Companies.
"Will [compounding] be less profitable then it is today? Probably," said Letson. "But I doubt it would be less profitable then if they lower the reimbursement for Xopenex."
As with most reimbursement cuts, there is a fear that price reductions will reduce the number of options for patients.
"Like anything else, if private businesses aren't compensated for providing a product, they are not going to do it," said one insider. "It's just that simple."