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Average Administrative Cost for Prescriptions

VA updates the average national administrative cost used for billing third party pharmacy prescription drugs for nonservice-connected disabilities every calendar year (CY).

CY 2018 Average Administrative Cost for Prescriptions

The average administrative charge is $16.64, which was based on VA’s national average administrative costs associated with prescriptions filled in a prior fiscal year. The CY 2018 average administrative cost used for billing pharmacy prescription claims was effective on January 1, 2018. For more information, please review the Reasonable Charges for Medical Care or Services; V3.23, 2018 Calendar Year Update and National Average Administrative Prescription Drug Charge Update: Federal Register, Vol. 82, No. 239..

CY 2017 Average Administrative Cost for Prescriptions

The average administrative charge is $16.36, which was based on VA’s national average administrative costs associated with prescriptions filled in a prior fiscal year. The CY 2017 average administrative cost used for billing pharmacy prescription claims was effective on January 1, 2017. For more information, please review the Reasonable Charges for Medical Care or Services; V3.21, 2017 Calendar Year Update and National Average Administrative Prescription Drug Charge Update: Federal Register, Vol. 81, No. 240.

CY 2016 Average Administrative Cost for Prescriptions

The average administrative charge is $14.29, which was based on VA’s national average administrative costs associated with prescriptions filled in a prior fiscal year. The CY 2016 average administrative cost used for billing pharmacy prescription claims was effective on January 1, 2016. For more information, please review the Reasonable Charges for Medical Care or Services; V3.18, 2016 Calendar Year Update and National Average Administrative Prescription Drug Charge Update: Federal Register, Vol. 80, No. 239.

CY 2015 Average Administrative Cost for Prescriptions

The CY 2015 average administrative charge was $13.10. For more information review the Reasonable Charges for Medical Care or Services; V3.16, 2015 Calendar Year Update and National Average Administrative Prescription Drug Charge Update: Federal Register, Vol. 79, No. 249.

CY 2014 Average Administrative Cost for Prescriptions

The CY 2014 average administrative charge was $13.07. For more information review the Reasonable Charges for Medical Care or Services; V3.14, 2014 Calendar Year Update and National Average Administrative Prescription Drug Charge Update: Federal Register, Vol. 78, No. 242.