Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 80.1
Oral Cancer Drugs
80.1 - Oral Cancer Drugs
(Rev. 1, 10-01-03)
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.