In the "Claims Submission" of the Provider Manual, the last bullet of the "Additional information concerning all compounded medications" sub-section (beginning on page 22), is deleted in its entirety and replaced with the following:
• Compounds may be covered for Medicare Part D Enrollees provided the compound contains at least one Part D covered drug. The item cost must only include components which satisfy the definition of a Covered Part D Drug as defined in 42 C.F.R. § 423.100. Components that are not Covered Part D Drugs as defined by the Centers for Medicare and Medicaid Services (CMS) may be included in the creation of the product, but may not be included in the calculation of the item cost submitted (e.g., sterile water, compounding bulk powders, vitamins, components not utilized for a diagnosis recognized in the compendia). Provider must, however, include all items used in the creation of the compounded product on the multi-ingredient claim transmission. Caremark accepts SCC 08 (Process Compound for Approved Ingredients) which will result in an adjudicated response on all items. Non- Covered Item(s) within a compound are not reimbursable.