Use this report to view the Self-Administered Drug (SAD) Exclusion List. See the drugs determined by the Medicare Administrative Contractors (MACs) to be usually self-administered and, therefore, excluded from Medicare coverage by law. The absence of a drug from this list does not necessarily mean the drug is covered by Medicare. Please contact your local contractor for information concerning a particular drug not found on this list.
For more information on Self-Administered Drugs, please see the
Medicare Benefit Policy Manual, Publication 100-2, Chapter 15, Section 50.2
Getting to know the Report
This report lists the Self-Administered Drug (SAD) Exclusion List articles and the article's CPT/HCPCS codes associated with the excluded drugs.
The columns in this report include:
- ID: The ID of the SAD Exclusion List article
- Contractor: The Medicare Administrative Contractor (MAC) responsible for the SAD Exclusion List article
- CPT/HCPCS Code: The CPT/HCPCS code of the excluded drug
- CPT/HCPCS Code Description: The CPT/HCPCS code description of the excluded drug
- Drug Brand Name: The drug brand name of the excluded drug
Filtering Your Report
You can filter your report by using the four criteria in the upper left. Changing the filters will immediately update your report.
Choose a date or date range to limit the report to only SAD Exclusion List articles that were effective on the specified date(s). By default, the report displays SAD Exclusion List articles that are currently in effect.
Choose from a list of MACs. Selecting one or more MACs will limit your report to only the SAD Exclusion List articles associated with the selected MACs. By default, all MACs are included in the report.
Enter a CPT/HCPCS code to limit the list of drugs returned by the report. By default, the report includes all drugs from the SAD Exclusion List articles. To include multiple CPT/HCPCS codes, enter CPT/HCPCS codes separated by a comma (e.g., "00800,04400")
Enter a drug keyword to limit the list of drugs returned by the report. By default, the report includes all drugs from the SAD Exclusion List articles. If a keyword is entered, drugs will only be included in the report if either the CPT/HCPCS Code Description or the Drug Brand Name column contains the keyword.
Sorting Your Report
You can sort your report by using the Sort By feature. Changing the sort will immediately update your report.
You can open a document by selecting the link in the ID column.
Printing a Document to PDF
There are multiple ways to create a PDF of a document that you are currently viewing. You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. Another option is to use the Download button at the top right of the document view pages (for certain document types).
At the bottom of the report, you will find additional helpful features:
- Report Run Date: The date you ran the report
- Selected Criteria: This is the criteria used to run the report
- Submit Feedback/Ask a Question: Use this feature to contact CMS
- Download to Excel: Use this feature to download all of the report data to an Excel file
AMA CPT / ADA CDT / AHA NUBC Copyright Statement
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not
recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services.
The AMA assumes no liability for data contained or not contained herein.
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