TMPPM 2008 > Texas Medicaid Services > Renal Dialysis Facility > Benefits and Limitations

40.3.4.4 Hematopoietic Agents, Erythropoietin Alfa (EPO), and Darbepoetin Alfa

Medicaid reimbursement is allowed for hematopoietic, EPO, and darbepoetin injections administered to chronic renal disease clients, chronic end-stage renal disease predialysis clients who have an anemia with a Hematocrit of 36 percent or less, and for clients with HIV infection who are being treated with Retrovir (AZT). Payment is limited to the end-stage renal dialysis facility and the physician in the office. EPO given for a hematocrit of 37 percent or above is not a benefit of the Texas Medicaid Program.

Refer to: "Hematopoietic Agents" for more information about hematopoietic agents, erythropoietin alfa (EPO), and darbepoetin alfa.