Medicare reports some confusion among Medicare Part B physicians
and pharmacies regarding the ability of Medicare Part B providers
to bill for drugs covered under Part D, the Medicare prescription
drug program.
In short, being an enrolled provider in the Medicare Part B
program does not impart Part D-related billing privileges.
Providers must have a separate contractual relationship with a
patient's Medicare prescription drug plan to receive payment for
the patient's covered prescription drugs.
Medicare Part B covers a limited number of prescription drugs
and biologicals that generally fall into three categories:
- Drugs furnished incident to a physician's service;
- Drugs furnished through a Medicare Part B covered item of
durable medical equipment (DME); and
- Drugs specifically covered by statute (for example, oral
immunosuppressive drugs).
These drugs will continue to be covered and paid for under Part
B after the Jan. 1, 2006, effective date for Part D.
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Last Updated On
October 23, 2015
Originally Published On
March 23, 2010