Temodar

Oral J8700 or injection J9328?

 The injection is excluded (SNF does not pay)  SNF pays for oral

 

noted 2/26/15

Gleevec

I was not able to find any evidence that Gleevec (aka imatinib) is excluded.  I believe the SNF pays 

Taxol is excluded

Neulasta - SNF pays

Avastin is excluded

J9035 Avastin or BEVACIZUMAB, INJECTION Major Category III. A. -Chemotherapy excluded

IVIG - Immunoglobulin - SNF must pay
http://www.cms.hhs.gov/transmittals/downloads/R1261CP.pdf

Q4087 Octagam Injection Injection, immune globulin (Octagam), intravenous, non-lyophilized (e.g. liquid), 500 mg
Q4088 Gammagard Liquid Injection Injection, immune globulin (Gammagard Liquid), intravenous, non-lyophilized (e.g. liquid), 500 mg
Q4091 Flebogamma Injection Injection, immune globulin (Flebogamma), intravenous, non-lyophilized (e.g. liquid), 500 mg
Q4092 Gamunex Injection Injection, immune globulin (Gamunex), intravenous, non-lyophilized (e.g. liquid), 500 mg

In addition, effective July 1, 2007, a new code for Rhophylac® has been established: Q4089 (injection, Rho(D) immune globulin (human), (Rhophylac), intramuscular or intravenous, 100 iu).
Another new HCPCS code, Q4090, will be effective July 1, 2007. The short description of code Q4090 is HepaGam B injection. In summary, the following HCPCS codes are effective July 1, 2007: Q4087, Q4088, Q4089, Q4090, Q4091, and Q4092.

Currently (5/15/07), Medicare Part B IVIG administered in hospital outpatient departments and in physician offices is reimbursed at 106% of the weighted average ASP. Medicare also makes a separate payment to physicians and hospital outpatient departments for pre-administration-related services associated with IVIG (HCPCS code G0332) to cover the effort to locate and acquire IVIG for administration

Rituxan / Rituximab 100 mg

HCPCS code J9310 Rituximab 100 mg is EXCLUDED from consolidated billing. The SNF does not pay.