The situation has been clarified in Transmittal 2312, posted by CMS. Under the guidelines, pharmacies may bill Medicare Part B for certain classes of drugs, including immunosuppressive, oral anti-emetic and oral anti-cancer. They may also bill for drugs self-administered through a piece of durable medical equipment.
Pharmacies and providers cannot bill Part B contractors for drugs dispensed directly to a patient for administration incident to a physician service, such as refilling an implanted drug pump. Pharmacies also cannot bill their DME Medicare administrative contractor for drugs furnished to a Medicare patient, unless the physician purchases the drugs from the pharmacy.
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