Immunosuppressive Drugs Furnished to Transplant Patients

70.1 - Immunosuppressive Drugs Furnished to Transplant Patients (Rev. 1, 10-01-03) Part B of Medicare covers FDA-approved immunosuppressive drugs. Payment is made for those immunosuppressive drugs that have been specifically labeled as such and approved for marketing by the FDA, as well as those prescription drugs, such as prednisone, that are used in conjunction with immunosuppressive drugs as part of a therapeutic regimen reflected in FDA-approved labeling for immunosuppressive drugs. Therefore, antibiotics, hypertensives, and other drugs that are not directly related to rejection are not covered. Deductible and coinsurance apply. SNFs bill using TOB 22X for Part B residents and TOB 23x for outpatients. See the Medicare Benefit Policy Manual, Chapter 15, "Covered Medical and Other Health Services," §§50 for coverage of drugs. See the Medicare Claim Processing Manual, Chapter 17, "Drugs," §§80 for billing and payment instructions.