Self-Administered Drug Exclusion List (A53033) - R36 - Effective April 1, 2024

Date Posted: April 4, 2024

This coverage article has been revised and published for notice under contract numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: April 1, 2024

Summary of Changes:

Added a double asterisk for J0801 and J0802. Under Article Text section added the following:

Note: the drugs represented by HCPCS codes J0801 and J0802 (marked with a double asterisk**) are administered by IM or SQ, therefore they require the JB modifier to be reported for the SQ administration and they should not have any modifier reported for IM administration.

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.

Last Updated Apr 04 , 2024