09/15/2025
WPS Recent Oncology Related News
Recent WPS Articles That May be of Interest to Oncology:
WPS PART A ONLY
None at this time.
WPS PART B ONLY
Hospital & Practitioner PTP Edits
Hospital PTP Edits
Effective October 1, 2025
- Hospital PTP Edits v313r0 (475,179 Records) 0001A/0591T -- 24346/G0471
- Hospital PTP Edits v313r0 (474,897 Records) 24350/11012 -- 36563/G0471
- Hospital PTP Edits v313r0 (474,985 Records) 36565/0213T -- 61626/G0471
- Hospital PTP Edits v313r0 (433,720 Records) 61630/0213T -- U0003/U0004
Practitioner PTP Edits
Effective October 1, 2025
- Practitioner PTP Edits v313r0 (675,009 Records) 0001A/0591T -- 25505/J2001
- Practitioner PTP Edits v313r0 (675,130 Records) 25525/01810 -- 37700/G0471
- Practitioner PTP Edits v313r0 (674,866 Records) 37718/0213T -- 62369/G0453
- Practitioner PTP Edits v313r0 (602,358 Records) 62370/0213T-- U0003/U0004
WPS PARTS A & B
None at this time.
MEDICARE HOT LINKS
Medicare Part B 2025 Fee Schedule
Effective January 1, 2025
- Loc 1 (file download)
- Loc 99 (file download)
- New! Medicare Part B Drug Pricing Files & Revisions: October Update (file download)
- New! Medicare Physician Fee Schedule Database: October Update (file download)
PFS National Payment Amount File
- ASP Pricing Files
- New! October 2025 ASP Pricing File - Preliminary File (file download)
- New! October 2025 NOC Pricing File - Preliminary File (file download)
- New! October 2025 ASP NDC-HCPCS Crosswalk - Preliminary File (file download)
- ASC Addenda
2025 Ambulatory Surgical Center (ASC) Fee Schedules
Anesthesia Pricing
2025 Final Rules & Fee Schedules
- 2025 Physician Fee Schedule Final Rule
- 2025 Physician Fee Schedules
- 2025 Specialty Pricing
- Physician Fee Schedule Final Rule Fact Sheet
- Quality Payment Program Fact Sheet
- Medicare Shared Savings Program in the CY 2025 PFS Final Rule Fact Sheet
- Medicare Prescription Drug Inflation Rebate Program Changes Fact Sheet
Calculating Specialist Pricing
For specialists, use the Physician Fee Schedule and the specific calculations below:
- Clinical Social Worker: multiply the fee amount by 75%
- Medical Nutrition Therapy: To determine the fee, multiply the fee amount by 85%
- Exception: The 85% calculation does not apply to Codes G0108 and G0109
- Nurse Practitioner/Physician Assistant/Clinical Nurse Specialist: To determine the fee, multiply the fee amount by 85%
- Exceptions: The 85% calculation does not apply to codes with a TC modifier, Technical Component Only codes, or CPT codes G0108 and G0109