Over the years, DIR fees have become a constant feature of almost every pharmacy network contract. According to Drug Channels, DIR fees accounted for an estimated 18 percent of total Medicare Part D rebates in 2019. Most pharmacy owners and operators are likely familiar with DIR fees, considering how pervasive they are. For the uninitiated, the Centers for Medicare and Medicaid Services (CMS) refers to DIR fees as “fees, payments, or payment adjustments made after the point-of-sale.”
