LCD ID Number: L39297 Status: A-Approved
LCD Title: Off-label Use of Rituximab and Rituximab Biosimilars
Geographic Jurisdiction: Wisconsin Other Jurisdictions
Original Determination Effective Date:
Original Determination Ending Date:
Revision Effective Date:
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act, Section 1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
Title XVIII of the Social Security Act, Section 1861(t)(2)(B) Drugs and Biologicals
Title XVIII of the Social Security Act, Section 1862(a)(1)(D) Investigational or Experimental
CMS Publication Pub 100-02, Medicare Benefit Policy Manual, Chapter 15:
50 - Drugs and Biologicals
50.4.5 - Off-Label Use of Drugs and Biologicals in an Anti-Cancer Chemotherapeutic Regimen
CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 17:
10 - Payment Rules for Drugs and Biologicals
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02/08/2023 08:52:17 184.108.40.206