Self-Administered Drug Exclusion List - R13, R14

The Self-Administered Drugs Exclusion List coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), 01312 (NV).

Effective Date: 09/18/19
Summary of Changes:
This article is a revision to update the effective date of the following drugs from 09/09-09/18/19 to give providers the 45-day notice.

  • J0599 - HAEGARDA
  • J3490 - Insulin Glargine (recombinant), Lantus Solostar, Adalimumab-adbm (Cyltezo)
  • J3590 - Abaloparatide (Tymlos), Sarilumab (Kevzara), Semaglutide (Ozempic), Fremanezumab-vfrm (Ajovy), Erenumab-aoooe (Aimovig), Alcanezumab-gnlm (Emgality)

View the locally hosted Self-Administered Drug Exclusion List.

View a complete list of Noridian coverage articles.

  • Go to Noridian Medicare Coverage Articles webpage
  • Scroll to bottom of page
  • Select state/contract link of interest from applicable Active, Future, or Retired Articles column
    • Link will redirect you to CMS MCD
  • In CMS MCD, select corresponding article title to view a comprehensive revision history for this article

            Last Updated Thu, 01 Aug 2019 09:42:11 +0000