Current through September 30, 2024
Section 409.25 - Drugs, biologicals, supplies, appliances, and equipment(a)Drugs and biologicals. Except as specified in paragraph (b) of this section, Medicare pays for drugs and biologicals as posthospital SNF care only if- (1) They represent a cost to the facility;(2) They are ordinarily furnished by the facility for the care and treatment of inpatients; and(3) They are furnished to an inpatient for use in the facility.(b)Exception. Medicare pays for a limited supply of drugs for use outside the facility if it is medically necessary to facilitate the beneficiary's departure from the facility and required until he or she can obtain a continuing supply.(c)Supplies, appliances, and equipment. Except as specified in paragraph (d) of this section, Medicare pays for supplies, appliances, and equipment as posthospital SNF care only if they are-(1) Ordinarily furnished by the facility to inpatients; and(2) Furnished to inpatients for use in the facility.(d)Exception. Medicare pays for items to be used after the individual leaves the facility if- (1) The item is one that the beneficiary must continue to use after leaving, such as a leg brace; or(2) The item is necessary to permit or facilitate the beneficiary's departure from the facility and is required until he or she can obtain a continuing supply, for example, sterile dressings.63 FR 26307, May 12, 1998