Medicare Benefit Policy Manual (Pub. 100-02), Ch. 15 § 50.4.2
Unlabeled Use of Drug
50.4.2 - Unlabeled Use of Drug
(Rev. 1, 10-01-03)
B3-2049.3
An unlabeled use of a drug is a use that is not included as an indication on the drug’s label as approved by
the FDA. FDA approved drugs used for indications other than what is indicated on the official label may be
covered under Medicare if the A/B MAC (B) determines the use to be medically accepted, taking into
consideration the major drug compendia, authoritative medical literature and/or accepted standards of
medical practice. In the case of drugs used in an anti-cancer chemotherapeutic regimen, unlabeled uses are
covered for a medically accepted indication as defined in §50.5.
These decisions are made by the MAC on a case-by-case basis.