Patients purchasing their own drugs or biologicals (brown bagging)
Medicare provides limited benefits for outpatient drugs. Drugs and/or biologicals purchased by the patient and taken to their physician's office for administration are not covered.
The program covers drugs that are furnished "incident to" a physician's service, provided the drugs are not usually self-administered by the patients who take them, and is reasonable and necessary for the diagnosis or treatment of the illness or injury according to accepted standards of medical practice.
To meet all the general requirements for coverage under the "incident to" provision, an FDA approved drug or biological must be:
- A type that is not usually self-administered;
- Furnished by a physician; and
- Administered by the physician, or by auxiliary personnel employed by the physician and under the physician’s personal supervision
The charge, if any, for the drug or biological must be included in the physician's bill and the cost of the drug or biological must represent an expense to the physician.
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