You may check with individual plans on their coding policies, or contact the Sandostatin LAR Depot Reimbursement Hotline for assistance with coding. Some payers may consider Sandostatin LAR Depot to be a chemotherapuetic drug and therefore may accept code J9999. The hospital will submit a claim to the insurer for Sandostatin LAR Depot administered in a hospital outpatient department. Hospitals use revenue codes developed by the American Hospital Association to bill for services and supplies furnished during an outpatient encounter. Reimbursement Reimbursement for Sandostatin LAR Depot will vary across insurers.
Most patients share the cost of medical care through copayments and deductibles.
However, patients insured by Medicaid and some managed care plans will have minimal or no copayments or deductibles. Private payers typically reimburse for physician services based on charges, discounted charges, or on a fee schedule. Private payers may reimburse for Sandostatin LAR Depot based on a percent of charges for the drug, average wholesale price, or according to a fee schedule. Most Medicaid programs reimburse physicians for their services according to a fee schedule, and for drugs according to estimated or actual acquisition cost. Most private payers reimburse for hospital outpatient care based on charges, discounted charges, or costs.