Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics)

Medicare covers an FDA‑approved oral 3‑drug antiemetic regimen (oral NK‑1 antagonist + oral 5‑HT3 antagonist + dexamethasone, HCPCS J8540) only when administered to beneficiaries receiving specified chemotherapeutic agents and when all Medicare statutory, coding, licensing, and documentation requirements are met. Suppliers must have appropriate state licensure/enrollment, a Standard Written Order/WOPD before billing or delivery, maintain proof of delivery, bill all drugs on the same claim, and may dispense no more than a one‑month supply (single course) with required beneficiary refill confirmation.

"Coverage requires that the item meet Medicare statutory criteria (eligible benefit category and be reasonable and necessary) per Social Security Act §1862(a)(1)(A)."

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