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US · guidance

CMS Pub. 100-04, ch. 17, § 80.1

Oral Cancer Drugs

activein force · 2026-08-25 – presentas-observed

A3 3660.13, SNF 536.1

Effective January 1, 1994, oral self administered versions of covered injectable cancer drugs furnished

may be paid if other coverage requirements are met. To be covered the drug must have had the same

active ingredient as the injectable drug. Effective January 1, 1999, this coverage was expanded to

include FDA approved Prodrugs used as anti-cancer drugs. A Prodrug may have a different chemical

composition than the injectable drug but body metabolizing of the Prodrug results in the same chemical

composition in the body.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
34a73fe90b66e263c2453984a3e0fc5308f143820e4deb742edbf764710c1e20
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