{"data":{"id":"us/42-cfr-414.701","jurisdiction":"us","citation":"42 CFR 414.701","heading":"Purpose.","body":"This subpart implements section 1842(o) of the Act by specifying the methodology for determining the payment allowance limit for drugs and biologicals covered under Part B of Title XVIII of the Act (hereafter in this subpart referred to as the “program”) that are not paid on a cost or prospective payment system basis. Examples of drugs that are subject to the rules contained in this subpart are: Drugs furnished incident to a physician's service; durable medical equipment (DME) drugs; separately billable drugs at independent dialysis facilities not under the ESRD composite rate; statutorily covered drugs, for example, influenza, pneumococcal, hepatitis, and COVID-19 vaccines, antigens, hemophilia blood clotting factor, immunosuppressive drugs and certain oral anti-cancer drugs.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES","Subpart I—Payment for Drugs and Biologicals"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"1141f61ed8ad72085db691327445d22aeb9830121ad0598cced757240de96f85","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-414.626","next":"us/42-cfr-414.704"},"notice":"GroundRules: Original legal text. Not legal advice."}