Introduction
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.
Date Criteria
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.
Contractor
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.
CPT/HCPCS Code(s):
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")
Drug keyword:
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.
Opening Documents
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).
Additional Features
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
CPT codes, descriptions, and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
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.
Current Dental Terminology © 2023 American Dental Association. All rights reserved.
Copyright © 2024, the American Hospital Association, Chicago, Illinois. Reproduced with permission.
No portion of the AHA copyrighted materials contained within this publication may be
copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and
descriptions may not be removed, copied, or utilized within any software, product, service, solution, or derivative work
without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.
Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes,
resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions;
and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only
authorized with an express license from the American Hospital Association.
The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or
accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the
preparation of this material, or the analysis of information provided in the material. The views and/or positions
presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are
not endorsed by the AHA or any of its affiliates.
