Effective April 18, 2016, the ‘Self Administered Drug Exclusion List’ is being updated.
The following drugs are being added to the list of drugs that Cahaba GBA has determined to be ‘usually self-administered by the patient’ and, therefore, not covered by Medicare.
- Evolocumab (Repatha™) – J3590
- Alirocumib (Praluent®) – J3590
Articles are located on the Medicare Coverage Database, (MCD), which can be accessed from the ‘Local Coverage Determination (LCD) & Articles’ page of the ‘Medical Review’ sections on the Cahaba GBA website.
Providers are encourages to review this information to ensure compliance.