CQW Panacea-re-brand-rev3

Pharmacy

For the Week of March 23, 2015

Question:

Are there any circumstances when hospitals can bill Medicare for self-administered drugs and receive reimbursement?

Answer:

According to the Medicare Benefit Policy Manual, hospitals may bill Part B for self-administered drugs when they are:

  • An integral component of a procedure or when they facilitate the performance of or recovery from a particular procedure
  • The treatment instead of being integral or directly related to the procedure, or facilitating the performance of or recovery from a particular procedure.

For details about the above go to section 50.2 at http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf.

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