Skip to Main Content

Print | Bookmark | | Font Size: + |

Administration of Medications

Medicare Benefit Policy Manual (CMS Pub. 100-02, Ch. 7 §40.1.2.4 and Ch.15 §50.5.4)External PDF

Intravenous, intramuscular, or subcutaneous injections and infusions, and hypodermoclysis or intravenous feedings require the skills of a licensed nurse to be performed or taught safely and effectively.

The medication must:

  • be safe and effective treatment for the beneficiary's illness;
  • have a stated reason for administration by injection rather than by a less invasive route; and
  • not exceed the frequency or duration of acceptable practice unless there is a valid explanation regarding a specific beneficiary condition that justifies the need for additional injections;
  • not be considered self administered. If it is a medication that CMS defines as self-administered, there must be documentation why the beneficiary is not able to administer, and that there is no willing or able caregiver to provide the injectable. For more information on self-administered drugs (SAD), please refer to the SAD local coverage determination (LCD).

Administration of oral, topical, or ocular medications is not considered a skilled service.

A limited number of parenteral drugs are paid for by Medicare. Calcitonin and Forteo are two of these drugs. Refer to "Calcitonin and Forteo" below for the requirements for billing the drug. For information on other drugs not listed, please see the Medicare Benefit Policy Manual (CMS Pub. 100-02, Ch. 15 §50.5.4)External PDF.

Updated: 12.20.21

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved