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Official Description

Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified
Short Descr Hiv prep, fda approved, noc
Coverage Special coverage instructions apply
Pricing Indicator(s) 46 – Supplies And Surgical Dressings - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts)
MPI A – Not applicable, as HCPCS priced under one methodology
MCM 2049
Statute 1861(ddd)
BETOS O1E – Other drugs
TOS Code(s) 1 – Medical care
Added Date 1/2/2024
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
ASC Payment Indicator Unclassified drugs and biologicals; payment contractor-priced.
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2024-01-02 Added Code added.
Code
Description
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