Tuesday, September 14, 2010

National Council for Prescription Drug Programs, NCPDP

What is NCPDP.

National Council for Prescription Drug Programs, Inc. (NCPDP) is an organization that promotes data interchange and processing standards to the pharmacy service sector of the healthcare industry.

The Scottsdale, Arizona-based National Council for Prescription Drug Programs (NCPDP) was founded in 1977 as the extension of a Drug Ad Hoc Committee that made recommendations for the US National Drug Code (NDC). NCPDP is a not-for-profit, ANSI-accredited, standards development organization  with over 1575 members representing virtually every sector of the pharmacy services industry. The diverse membership provides leadership and healthcare business solutions through education and standards, created using the consensus building process. NCPDP has been named in US federal legislation, including Health Insurance Portability and Accountability Act and the Medicare Prescription Drug, Improvement, and Modernization Act. NCPDP members have created standards such as the Telecommunication Standard and Batch Standard, the SCRIPT Standard for Electronic Prescribing, the Manufacturers Rebate Standard and more to improve communication within the pharmacy industry. 
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download