This section covers a wide variety of medical and surgical supplies, as well as some DME-related supplies and accessories. Medicare generally covers DME-related supplies, accessories, maintenance, and repair under the prosthetic devices provision.
Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie
Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries
Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries
Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries
Sodium phosphate p-32, therapeutic, per millicurie
Chromic phosphate p-32 suspension, therapeutic, per millicurie
Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries
Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries
Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
Continued
Indium in-111 labeled autologous white blood cells, diagnostic, per study dose
Indium in-111 labeled autologous platelets, diagnostic, per study dose
Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
Injection, gadopiclenol, 1 ml
Injection, gadoterate meglumine, 0.1 ml
Injection, gadoteridol, (prohance multipack), per ml
Injection, gadobenate dimeglumine (multihance), per ml
Injection, gadobenate dimeglumine (multihance multipack), per ml
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml
Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
Injection, gadoxetate disodium, 1 ml
Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
Injection, gadofosveset trisodium, 1 ml
Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
Injection, gadobutrol, 0.1 ml
Florbetapir f18, diagnostic, per study dose, up to 10 millicuries
Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
Fluciclovine f-18, diagnostic, 1 millicurie
Instillation, hexaminolevulinate hydrochloride, 100 mg
Iodine i-131, iobenguane, 1 millicurie
Continued
Fluoroestradiol f 18, diagnostic, 1 millicurie
Copper cu-64, dotatate, diagnostic, 1 millicurie
Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie
Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie
Piflufolastat f-18, diagnostic, 1 millicurie
Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified
Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified
Strontium sr-89 chloride, therapeutic, per millicurie
Flortaucipir f 18 injection, diagnostic, 1 millicurie
Fluorodopa f-18, diagnostic, per millicurie
Injection, pafolacianine, 0.1 mg
Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
Radium ra-223 dichloride, therapeutic, per microcurie
Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie
Flotufolastat f 18, diagnostic, 1 millicurie
Fludeoxyglucose f18 up to 15 millicuries
Xenon xe-129 hyperpolarized gas, diagnostic, per study dose
Flurpiridaz f 18, diagnostic, 1 millicurie