MEDICARE COVERAGE POLICY
Updated as of January 6, 2009
When used for anti-cancer chemotherapy, Xeloda is eligible for coverage under traditional Medicare Part B as well as under other Medicare Health Plans, including Medicare Advantage plans.
The information on this page primarily addresses Medicare Part B coverage of Xeloda through the regional Durable Medical Equipment Medicare Administrative Contractors (DMEMACs) as well as links to important Centers for Medicare & Medicaid Services (CMS), and Medicare web sites. Contact the Xeloda Reimbursement Hotline if you have any questions about the content below or any other Xeloda reimbursement issues.
Medicare Part B Local Coverage Determinations (LCD): Coverage for Approved Oral Anti-Cancer Drugs
CMS and Medicare Information
- Centers for Medicare and Medicaid Services (CMS) Homepage
- Medicare Claims Processing Manual
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Chapter 17 - Drugs and Biologicals
- Chapter 17 - Supplemental Chapters & Transmittals
- Medicare Benefit Policy Manual
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Chapter 15 - Covered Medical and other Health Services
- Chapter 15 - Supplemental Chapters & Transmittals
- CMS Regulation and Guidance Page
- XELODA Standard Coverage Statement
Private Payers
Private payer coverage varies according to payer, plan, and patient. Individual patient-benefits should be verified to ensure accurate understanding of a patient's health benefits. For help with benefit verifications, contact the Oncoline Reimbursement Hotline at 1-800-443-6676.
