Article Detail - JF Part A
Self-Administered Drug Exclusion List (A53033) - R38 - Effective July 1, 2024
Date Posted: July 5, 2024
This coverage article has been revised and published for notice under contract numbers: 02101 (AK), 02201 (ID), 02301(OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).
Effective Date: July 1, 2024
Summary of Changes:
The article has been updated to add a new code (Q5137) for Ustekinumab-auub (Wezlana) effective for dates of service on or after 7/1/2024. The previous miscellaneous codes C9399, J3490, and J3590 have been deleted. A new code (J2267) for Mirikizumab-mrkz* has been added effective for dates of service on or after 7/1/2024. The previous miscellaneous codes C9399, J3490, and J3590 have been deleted.
The new drug code (J1748) Infliximab-dyyb (Zymfentra) has been added to SAD list with effective for dates of service on or after 8/18/2024.
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 Medicare Coverage Articles webpage.
