Self-Administered Drug Exclusion List (A53033) - R47 - Effective October 15, 2021

Date Posted: May 21, 2026

This billing and coding 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: October 15, 2021

Summary of Changes:

Under Excluded CPT/HCPCS Codes, added J3357, Stelara® subcutaneous, back to the SAD listing as it was removed in error with the previous revision.

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.

Last Updated May 21 , 2026