The Coinsurance List CMS Stopped Publishing
Eighty-four Part B drug codes carry a reduced patient coinsurance from October 1, down from 107 in the current quarter. CMS has not published the quarterly list since March 2025, so the only source is a Notes column in a spreadsheet, and we diffed it: 31 codes out, 8 in, and a modeled $38.6 million a year of patient relief gone.
If you infuse or inject anything separately payable under Part B, your billing system holds a patient coinsurance percentage for each of those codes, and on October 1 that percentage goes wrong on 39 of them.
31 drugs lose the reduced coinsurance they carry today. 8 pick one up.
The change is effective October 1 and the only place it has been published is the
Notes column of a spreadsheet inside a zip file on the ASP pricing page.
That is not a figure of speech. CMS used to put out a plain quarterly PDF, "Reduced Coinsurance for Certain Part B Rebatable Drugs," naming every drug with an adjusted patient share.
The newest one on the Medicare Inflation Rebate Program page today covers January 1 to March 31, 2025. The quarter starting in seventeen days will be the seventh in a row with no published list.
"Who is checking the patient's share on these codes if the agency stopped printing the list?"
We parsed every quarterly pricing file since the adjustment began in April 2023 and diffed the October file against July's.
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