Self-Administered Drug Exclusion List - R23, Effective May 15, 2021

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: 05/15/2021
Summary of Changes: The article is updated to add: The article is updated to add: J1628, Injection, Guselkumab, (Tremfya®)1mg, effective 5/15/2021.

The asterisk does not apply to J3357 and therefore has been removed.

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 Thu, 01 Apr 2021 13:23:30 +0000