Provider Manual
20 PRESCRIPTION DRUG COVERAGE
20.3 Part B Prescription Drugs
Prescription drugs covered under the Medicare Part B benefits are very limited. These include the following:
- Injectable medications provided incedental to a physician's service
- Drugs administered through covered DME, such as a nebulizer or infusion pump in the home
- Certain oral cancer medications
- Antiemetic drugs administered within 48 hours of chemotherapy
- Immunosuppressive drugs prescribed following a Medicare-covered organ transplant
- Erythropoietin for individuals undergoing chronic renal dialysis
- Parenteral nutrition for members with a permanent dysfunction of the digestive tract
Other drugs may be covered under Part B in certain limited situations. Many Part B drugs and injectable medications provided incidental to a physician’s service require precertification from IntegraNet. Please call 281-591-5289 for additional information.