Self-Administered Drug Exclusion List (A53033) - R40 - Effective September 11, 2024

Date Posted: September 26, 2024

This coverage article has been revised and published for notice under contract numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: September 11, 2024

Summary of Changes:

EXCLUDED CPT/HCPCS CODES:

Removed: Asterisk (*) from J3590, J3490, and C9399 secukinumab (Cosentyx) subcutaneous use. This is effective 07/01/2024.

Added: Asterisk (*) to J1628 guselkumab (Tremfya®)*. This is effective 09/11/2024.

09/26/2024: At this time, 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Visit the Self-Administered Drugs (SADs) webpage to view the Self-Administered Drug Exclusion List.

To view the complete listing of coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD, visit the Billing and Coding Articles webpage.

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