US · guidance
CMS Pub. 100-02, ch. 1, § 30.4
Drugs Specially Ordered for Inpatients
A3-3101.3.D, HO-210.3.D
Coverage is not limited to drugs and biologicals routinely stocked by the hospital; a drug
or biological not stocked by the hospital, which the hospital obtains for the patient from
an outside source, such as a community pharmacy, can also be covered.
Drugs and biologicals not included in the drug list or formulary maintained by the
hospital's pharmacy and drug therapeutics committee may be covered if the hospital has a
policy which permits such drugs to be furnished to a patient at the special request of a
physician. However, in order to be covered, such drugs and biologicals must be included,
or approved for inclusion, in one of the designated drug compendia. (In addition, a
combination drug, or all of its therapeutic ingredients, would have to be included or
approved for inclusion in one of the compendia.)
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
bc73877f2623c15c7467230cce2ac03725440bbb3266345cb297d0e8f95992fe
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