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Welcome to the Guide for Healthcare Professionals on Drugs
and Products Eligible for Medicare Part B and/or Part D
Coverage
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PartBorPartD.com
is an online informational, searchable, database that is
designed to provide healthcare professionals guidance on
determining when a drug or product should be billed under the
Medicare Part B or Part D Program.
PartBorPartD.com
also provides CMS resources to assist pharmacists and other
healthcare professionals with requesting Prior Authorization and
navigating the CMS Appeals Process.
Drugs included in this database may be eligible for coverage
under:
- Medicare Part B Only
- Medicare Part D Only
- Either Medicare Part B or Part D under certain
circumstances
- Neither Medicare Part B nor Part D
Examples of some
of the drug classes, under certain circumstances,
that may be eligible for coverage under Medicare Part B
Only
• Injectable Anti-neoplastics
• Injectable Anti-infectives
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Examples of some
of the drug classes, under certain circumstances,
that may be eligible for coverage under Medicare Part D
Only
• Anti-hyperlipidemia agents
• Oral diabetic medications
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Examples of some
of the drug classes, under certain circumstances,
that may be eligible for coverage under Medicare Part B or
Part D:
• Oral Anti-emetics
• Immunosuppressants
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Examples of some
of the drug classes, under certain circumstances,
that may not be eligible for coverage under Medicare Part
B or Part D:
• Over-the-Counter agents (except Insulin)
• Cosmetic Agents
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The
PartBorPartD.com
website was developed and is maintained by R•J Health Systems International,
LLC. The reimbursement drug or product codes referenced on this
website are a component of the CMS (Centers for Medicare and
Medicaid Services) HCPCS (Healthcare Common Procedure Coding
System) and the AMA's (American Medical Association) CPT®
(Current Procedural Terminology) coding systems.
Contact us to subscribe to PartBorPartD.com
CPT® copyright 2010 American Medical Association. All rights reserved. CPT® is a registered
trademark of the American Medical Association
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