Review Reminder on Billing Point-of-Use Convenience Kits

July 15, 2025

We regularly review claims submitted by providers to ensure that benefits provided are for services included in our members’ benefit plans and meet our guidelines.

Some providers have submitted claims for point-of-use convenience kits used in the administration of injectable medicines. In addition to the injectable medicine, these prepackaged kits include supply items, such as alcohol prep pads, cotton balls, disposable sterile medical gloves, povidone-iodine swabs, adhesive bandages and gauze. 

Reminder: We reimburse providers for only the drug component of the kit.

We also periodically check the pricing of these kits to manage costs. The cost of these convenience kits is often more than the cost of their components purchased separately. These non-drug supplies are considered part of the practice expense for the procedure performed, and no added compensation is warranted. Reimbursement for point-of-use convenience kits may be updated based on the Food and Drug Administration-approved drug component.

For more details, check the provider manual for pharmacy program management information.

The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. Members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any medication is between the member and their health care provider.