Current through February 29, 2024
Section 414.900 - Basis and scope(a) This subpart implements sections 1842(o), 1847A, and 1847B of the Act and outlines two payment methodologies applicable to drugs and biologicals covered under Medicare Part B that are not paid on a cost or prospective payment system basis.(b) Examples of drugs that are subject to the requirements specified in this subpart are: (1) Drugs furnished incident to a physician's service; durable medical equipment (DME) drugs.(2) Separately billable drugs at independent dialysis facilities not under the ESRD composite rate.(3) Statutorily covered drugs, for example- (ii) Pneumococcal, Hepatitis B, and COVID-19 vaccines.(iv) Hemophilia blood clotting factor.(v) Immunosuppressive drugs.(vi) Certain oral anti-cancer drugs.69 FR 66424, 11/15/2004, as amended at 70 FR 39093, 7/6/2005; 85 FR 71197, 11/6/2020