Self-Administered Drug Exclusion List:

Medicare excludes outpatient drugs that are 'usually self-administered' by more than 50% of Medicare beneficiaries for a given indication. Intravenous and intramuscular injectables, short-term (less than 2 weeks) or drugs administered in acute settings, and drugs given infrequently (e.g., ~monthly) are more likely to be covered; subcutaneous, oral, topical, and frequently administered (weekly or more) drugs are more likely to be excluded. Coverage determinations are made per drug/indication using route, acuity, setting, frequency, claims data, and accepted objective evidence; required claim modifiers (JA/JB) must be used for multi-route HCPCS codes or claims may be denied.

"Injectable drugs administered intravenously (IV) are presumed to be 'not usually self-administered' and therefore meet Medicare benefit category requirements for coverage when furnished incident-to..."