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Introduction Commercial Payer Prior Authorization Medicare Part D Prior Authorization Please see full Prescribing Information, including Boxed WARNINGS, for PROCRIT® (Epoetin alfa) Medicare Guideline Archives Medicare Guideline Update Table CMS 1450 / UB-04

State Medicare Guidelines / CMS 1500
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BILLING & REIMBURSEMENT

Medicare Guideline Update Table

Select State or Region




A

Alabama

Part A - Updated December 09, 2009

Part B - Updated December 03, 2009

Alaska

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010

Arizona

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010

Arkansas

Part A - Updated March 07, 2010

Part B - Updated November 30, 2009
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C

California

Part A - Updated April 19, 2010

Part B - Updated July 22, 2010

Colorado

MAC - Updated June 11, 2010

Connecticut

Part A - Updated June 01, 2010

Part B - Updated June 01, 2010
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D

Delaware

MAC - Updated March 10, 2010

District of Columbia

MAC - Updated March 10, 2010
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F

Florida

Part A - Updated October 29, 2009

Part B - Updated October 29, 2009
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G

Georgia

Part A - Updated December 09, 2009

Part B - Updated December 03, 2009
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H

Hawaii

Part A - Updated April 19, 2010

Part B - Updated July 22, 2010
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I

Idaho

Part A - Updated December 16, 2009

Part B - Updated October 01, 2009

Illinois

Part A - Updated June 01, 2010

Part B - Updated March 07, 2010

Indiana

Part A - Updated June 01, 2010

Part B - Updated June 01, 2010

Iowa

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010
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K

Kansas

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010

Kentucky

Part A - Updated June 01, 2010

Part B - Updated June 01, 2010
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L

Louisiana

Part A - Updated May 03, 2010

Part B - Updated November 30, 2009
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M

Maine

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010

Maryland

MAC - Updated March 10, 2010

Massachusetts

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010

Michigan

Part A - Updated June 01, 2010

Part B - Updated March 07, 2010

Minnesota

Part A - Updated December 16, 2009

Part B - Updated March 07, 2010

Mississippi

Part A - Updated May 03, 2010

Part B - Updated January 01, 2010

Missouri

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010

Montana

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010
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N

Nebraska

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010

Nevada

Part A - Updated April 19, 2010

Part B - Updated July 22, 2010

New Hampshire

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010

New Jersey

MAC - Updated March 10, 2010

New Mexico

MAC - Updated June 11, 2010

New York

Part A - Updated June 01, 2010

Part B - Updated June 01, 2010

North Carolina

Part A - Updated July 01, 2008

Part B - Updated October 01, 2009

North Dakota

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010
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O

Ohio

Part A - Updated June 01, 2010

Part B - Updated July 09, 2009

Oklahoma

MAC - Updated June 11, 2010

Oregon

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010
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P

Pennsylvania

MAC - Updated March 10, 2010
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R

Rhode Island

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010
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S

South Carolina

Part A - Updated July 01, 2008

Part B - Updated December 01, 2009

South Dakota

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010
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T

Tennessee

Part A - Updated December 09, 2009

Part B - Updated December 03, 2009

Texas

MAC - Updated June 11, 2010
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U

Utah

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010
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V

Vermont

Part A - Updated March 07, 2010

Part B - Updated March 07, 2010

Virginia

Part A - Updated June 01, 2010

Part B - Updated June 11, 2010
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W

Washington

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010

West Virginia

Part A - Updated June 01, 2010

Part B - Updated July 09, 2009

Wisconsin

Part A - Updated June 01, 2010

Part B - Updated March 07, 2010

Wyoming

Part A - Updated December 16, 2009

Part B - Updated January 13, 2010
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Important Safety Information for PROCRIT® (Epoetin alfa)

WARNINGS: INCREASED MORTALITY, SERIOUS CARDIOVASCULAR EVENTS, THROMBOEMBOLIC EVENTS, STROKE and INCREASED RISK OF TUMOR PROGRESSION OR RECURRENCE

Chronic Renal Failure:
  • In clinical studies, patients experienced greater risks for death, serious cardiovascular events, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target hemoglobin levels of 13 g/dL and above.

  • Individualize dosing to achieve and maintain hemoglobin levels within the range of 10 to 12 g/dL.
Cancer:
  • ESAs shortened overall survival and/or increased the risk of tumor progression or recurrence in some clinical studies in patients with breast, non-small cell lung, head and neck, lymphoid, and cervical cancers (see WARNINGS: Table 1).

  • To decrease these risks, as well as the risk of serious cardio- and thrombovascular events, use the lowest dose needed to avoid red blood cell transfusion.

  • Because of these risks, prescribers and hospitals must enroll in and comply with the ESA APPRISE Oncology Program to prescribe and/or dispense PROCRIT® to patients with cancer. To enroll in the ESA APPRISE Oncology Program, visit www.esa-apprise.com or call 1-866-284-8089 for further assistance.

  • Use ESAs only for treatment of anemia due to concomitant myelosuppressive chemotherapy.

  • ESAs are not indicated for patients receiving myelosuppressive therapy when the anticipated outcome is cure.

  • Discontinue following the completion of a chemotherapy course.
Perisurgery: PROCRIT® (Epoetin alfa) increased the rate of deep venous thromboses in patients not receiving prophylactic anticoagulation. Consider deep venous thrombosis prophylaxis.

(See WARNINGS: Increased Mortality, Serious Cardiovascular Events, Thromboembolic Events, and Stroke, WARNINGS: Increased Mortality and/or Increased Risk of Tumor Progression or Recurrence, INDICATIONS AND USAGE, and DOSAGE AND ADMINISTRATION.)

Please see full Prescribing Information, including Boxed WARNINGS for PROCRIT® (Epoetin alfa)

Medication Guide for PROCRIT®
Please read the Medication Guide for PROCRIT® and discuss with your doctor.

Patient Instructions for Use
Instructions if you or your caregiver has been trained to give PROCRIT® injections at home.




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