Reimbursement Newsletter

RJ Health provides insight into new drugs and devices, code price updates and more as it applies to medically covered drugs.

Specialty Drug Reimbursement Newsletter | May 2025

May

12

2025

RJ Health, an MMIT company, delivers industry standard specialty drug pricing, coding and reimbursement solutions to support payer and provider alignment.

Every month, our team evaluates a variety of pricing and coding updates. In the May edition of the Specialty Drug Reimbursement Newsletter, we identified 85 drug code price changes this month, with 38 of them being price decreases. We have also identified drugs to be added or updated within our database. Preview some of these insights below:

This month, during our review of the 3482 Reimbursement HCPCS/CPT® Codes in our system, we identified 85 Drug Codes that required a recalculation of their AWP Code Price. Clients can log in to www.ReimbursementCodes.com to view the pricing updates for these codes.

A4216 J0613 J1938 J3110 J9345
A4247 J0640 J1939 J3145 J9349
A4253 J0641 J1953 J3230 Q0161
A4627 J0775 J2250 J3246 Q0162
A7005 J0780 J2251 J3285 Q4160
A7015 J0878 J2290 J3357 Q4227
B4103 J1096 J2326 J3358 Q4294
B4153 J1162 J2354 J7336 Q4295
B4155 J1202 J2515 J7510 Q4298
B4157 J1203 J2543 J9000 Q4344
B4162 J1301 J2597 J9032 Q4367
E0570 J1302 J2690 J9119 Q9968
E0607 J1304 J2710 J9172 Q9996
J0171 J1437 J2786 J9205 Q9997
J0174 J1448 J2860 J9226 S0109
J0278 J1552 J2998 J9245 S0119
J0603 J1644 J3105 J9307 S0122

ReimbursementCodes was designed for organizations like yours to manage pricing, coding and clinical challenges related to specialty drugs. To gain access to this tool and view the rest of the insights we captured this month, visit our site or contact marketing@mmitnetwork.com.

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