Question:

What are the criteria points for EPO coverage regarding anemia patients with chronic renal failure?

Answer:

Erythropoietin (EPO) is covered for the treatment of anemia for patients with chronic renal failure who are on dialysis when one of the following are true.

  • It is administered in the renal dialysis facility 
  • Or EPO is self-administered in the home by any dialysis patient (or patient caregiver) who is determined competent to use the drug and meets the other conditions specified in the Medicare Benefit Policy Manual.
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