Question:
Does the incident-to policy affect Medicare payment for drugs?
Answer:
In order to meet all the general requirements for coverage under the incident-to provision, drugs and biologicals must be approved by the Food & Drug Administration (FDA). They must be a form that is not usually self-administered and must be furnished and administered by a physician or by auxiliary personnel employed by the physician and under the physician’s personal supervision.
If there is a charge for the drug or biological, it must be included in the physician’s bill, and the cost must represent an expense to the physician.
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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