Can I bill for drug wastage from a multi-dose/multiuse vial or package of drug or biological?

Answer:

  • Providers may not bill for drug wastage for multi-does/multiuse vials or packages from which an amount is administered to one patient
  • Even if a provider is unable to store unused doses for later use because the pharmacy incorrectly reconstituted the drug using sterile water instead of bacteriostatic water, a provider may not bill for drug wastage in a multi-dose/multiuse vial or package

Tips for Submitting Accurate Claims:

  • Each HCPCS code is associated with a specific number of units and type of units may be described by various units of measure
  • Verify the number and type of units associated with the HCPCS code before calculating the quantity on your claim
  • Verify calculations with the physician if needed
  • Submit the number of units (based on the HCPCS code) for the amount actually administered and not the number of units in the entire multi dose/multiuse vial or package

Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

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