Question:
Does Medicare separately pay for drugs used during procedures?
Answer:
Payment for drugs and supplies used in the performance of procedures is included in the fee for the procedure, which is not separately billable to Medicare or the beneficiary. The Medicare exclusion is clear for oral drugs, suppositories and topical medications. Drugs that are covered as an integral part of the procedure (e.g., a topical ophthalmic anesthetic) are not separately reimbursed but considered part of the fee for the procedure.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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