Pharmacy Question for the Week of November 27, 2017

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.