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Contractor Information

Contractor Name: National Government Services, Inc. - Full list of policies of this Medicare Contractor Contractor Number: 14512 Contractor Type: MAC B

LCD Information

LCD ID Number: L39297 Status: A-Approved LCD Title: Off-label Use of Rituximab and Rituximab Biosimilars Geographic Jurisdiction: Vermont Other Jurisdictions Original Determination Effective Date: 11/01/2022 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 Publications 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 Sorry, you need to login or register to view additional sections of this Medicare policy. *