The number used to identify the prescription order number for drugs and biologicals purchased through the competitive acquisition program (CAP).
The prescription order number consists of:
- Vendor ID number (positions 1–4)
- HCPCS code (positions 5–9)
- Vendor controlled prescription number (positions 10–30)
The Medicare Modernization Act (MMA) required CMS to implement at a competitive acquisition program (CAP) for Part B drugs and biologicals not paid on a cost or PPS basis. Physicians have a choice between buying and billing these drugs under the average sales price (ASP) or obtaining these drugs from an approved CAP vendor. The prescription number is needed to identify which claims were submitted for CAP drugs and their administration.