Reply To: Rituxan and Medicare

Jim-LA
December 2, 2021 at 3:23 pm

Medicare covers Rituximab costs under Part B for certain conditions. Following is the latest summary:

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35026&ver=69

Depending on which Medicare Advantage plan you have, coverage will vary. Here is the Blue Shield California coverage statement:

https://www.blueshieldca.com/bsca/bsc/public/common/PortalComponents/provider/StreamDocumentServlet?fileName=PRV_MP_medicare_rituximab.pdf

Billing and Coding is crucial in getting Medicare coverage:

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56380&ver=43

I had my Rituximab treatment covered under Medicare.  My experience with the treatments can be found here:

Anemia Due To CIDP?