Self-Administered Drug Exclusion List - R24, Effective May 15, 2022

This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).

Effective Date: May 15, 2022

Summary of Changes: The article is updated to add: Risankizumab-rzaa (Skyrizi™) - C9399, J3490, J3590.

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

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

Last Updated Mar 31 , 2022