Article Detail - JE Part A
Self-Administered Drug Exclusion List (A53032) - R44 - Effective January 1, 2026
Date Posted: January 2, 2026
This billing and coding article has been revised and published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).
Effective Date: January 1, 2026
Summary of Changes:
EXCLUDED CPT/HCPCS CODES:
Deleted: J2940 Somatrem, 1 mg (Protropin); J3355 Urofollitropin, 75 IU (Metrodin, Bravelle, Ferinex); and J9212 Interferon Alfacon-1, Recombinant, 1 microgram (Infergen)
NON-EXCLUDED CPT/HCPCS CODES:
Deleted: J1562 Injection, Immune Globulin (Vivaglobin), 100 mg
Visit the Self-Administered Drugs (SADs) webpage to view the Self-Administered Drug Exclusion List.
To view the complete listing of billing and coding articles and/or access the Active, Future, or Retired articles available in the CMS MCD, visit the Billing and Coding Articles webpage.
