Pharmacy Question for the Week of January 28, 2019

Question:

What are the criteria requirements for incident-provision drugs?

Answer:

In order to meet all the general requirements for coverage under the incident-to provision, an FDA approved drug or biological must be:

A form that is not usually self-administered
Furnished by a physician
Administered by the physician or by auxiliary personnel employed by the physician and under the physician’s personal supervision.

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.

Pharmacy Question for the Week of January 28, 2019

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