tci Medicare Compliance & Reimbursement - 2004 Issue 27

COVERAGE: Injectible Cancer Drugs Put On Pass-Through List

But don't get used to the new money just yet. The Centers for Medicare & Medicaid Services added five new medications and one new technology to the pass-through payment list, effective July 1 -- but because CMS doesn't have enough cost information yet, the current reimbursement amount could change. Four of the five new drugs are injectable therapies for cancer patients: Pemetrexed, Bevacizumab, Cetuximab, and Abarelix, some of which hopefully come with a nickname. You'll also score pass-through payment for Omalizumab, an injectable medication for allergy-induced asthma. If providers administered any of these drugs before the July 1 implementation...

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