CMS Pub. 100-04, ch. 12, § 20.4.4

B3-15900.2

A/B MACs (B) make a separate payment for supplies furnished in connection with a procedure

only when one of the two following conditions exists:

A. HCPCS code A4300 is billed in conjunction with the appropriate procedure in the Medicare

Physician Fee Schedule Data Base (place of service is physician’s office). However, A4550,

A4300, and A4263 are no longer separately payable as of 2002. Supplies have been

incorporated into the practice expense RVU for 2002. Thus, no payment may be made for

these supplies for services provided on or after January 1, 2002.

B. The supply is a pharmaceutical or radiopharmaceutical diagnostic imaging agent (including

codes A4641 through A4647); pharmacologic stressing agent (code J1245); or therapeutic

radionuclide (CPT code 79900). Other agents may be used which do not have an assigned

HCPCS code. The procedures performed are:

• Diagnostic radiologic procedures (including diagnostic nuclear medicine) requiring

pharmaceutical or radiopharmaceutical contrast media and/or pharmacologic stressing agent;

• Other diagnostic tests requiring a pharmacologic stressing agent;

• Clinical brachytherapy procedures (other than remote after-loading high intensity

brachytherapy procedures (CPT codes 77781 through 77784) for which the expendable source

is included in the TC RVUs); or

• Therapeutic nuclear medicine procedures.

Drugs are not supplies, and may be paid incidental to physicians’ services as described in

Chapter 17.