LCD/NCD Portal

NCD130.7

 

WITHDRAWAL TREATMENTS FOR NARCOTIC ADDICTIONS

 

Effective Date of this Version

• This is a longstanding national coverage determination.

• The effective date of this version has not been posted.

 

Benefit Category

• Drugs and Biologicals.

• Incident to a physician's professional Service.

• Physicians' Services.

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

Indications and Limitations of Coverage

• Withdrawal is an accepted treatment for narcotic addiction, and Part B payment can be made for these services if they are provided by the physician directly or under his personal supervision and if they are reasonable and necessary.

o In reviewing claims, reasonableness and necessity are determined with the aid of the contractor's medical staff.

• Drugs that the physician provides in connection with this treatment are also covered if they cannot be self-administered and meet all other statutory requirements.

 

Cross Reference

• See the Medicare Benefit Policy Manual, Chapter 6 §20.4.1.

 

Medicare NCD Link