Self-Administered Drug Exclusion List - R14, R15
The Self-Administered Drugs Exclusion List 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), 03601 (WY).
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.
- Go to Self-Administered Drugs (SADs) webpage
View a complete list of Noridian coverage articles.
- Go to Noridian Medicare Coverage Articles webpage
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- 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 Aug 01, 2019