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As part of this revised definition of primary care services used for assigning beneficiaries under 425.402, we proposed to incorporate a provision in 425.400(c)(1)(ix)(C), specifying that the primary care service codes for purposes of assigning beneficiaries include a CPT code identified by CMS that directly replaces a CPT code specified in 425.400(c)(1)(ix)(A) or a HCPCS code specified in 425.400(c)(1)(ix)(B), when the assignment window or expanded assignment window (as defined in 425.20) for a benchmark or performance year includes any day on or after the effective date of the replacement code for payment purposes under FFS Medicare

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Youll then be responsible for either 5% of the retail drug cost or $3.70 copay for generic/$9.20 copay for a brand name drug, whichever is cheaper