{"data":{"id":"us/42-cfr-414.900","jurisdiction":"us","citation":"42 CFR 414.900","heading":"Basis and scope.","body":"(a) This subpart implements sections 1842(o), 1847A, and 1847B of the Act and outlines two payment methodologies applicable to drugs and biologicals covered under Medicare Part B that are not paid on a cost or prospective payment system basis.\n(b) Examples of drugs that are subject to the requirements specified in this subpart are:\n(1) Drugs furnished incident to a physician's service; durable medical equipment (DME) drugs.\n(2) Separately billable drugs at independent dialysis facilities not under the ESRD composite rate.\n(3) Statutorily covered drugs, for example—\n(i) Influenza.\n(ii) Pneumococcal, Hepatitis B, and COVID-19 vaccines.\n(iii) Antigens.\n(iv) Hemophilia blood clotting factor.\n(v) Immunosuppressive drugs.\n(vi) 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 K—Payment for Drugs and Biologicals Under Part B"],"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":"96d0d6e94f31acc02fd48d1f51d3483f1c0edeff004bfc185e24285642ecc9cc","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-414.806","next":"us/42-cfr-414.902"},"notice":"GroundRules: Original legal text. Not legal advice."}