US · guidance
CMS Pub. 100-04, ch. 13, § 50.2.1
A/B MAC (A) Payment for IV Persantine
The A/B MACs (A) pay drug IV Persantine based on the drug pricing methodology when used in
conjunction with nuclear medicine and cardiovascular stress testing procedures furnished to SNF
outpatients. Separate drug pricing methodology payments for IV Persantine is made in addition to
payments made for the procedure. SNFs bill HCPCS code J1245 (injection, dipyridamole, per 10 mg.)
with revenue code 0636.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
15ada6e4bb9d1baa917c1fd93d08e9764d7b940b0211b8ffc0f1673f0be69605
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